SEARCH · Search PubMed

Results for “SOCIAL CLASS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources

PubMed1997

Measuring social class in US public health research: concepts, methodologies, and guidelines.

Increasing social inequalities in health in the United States and elsewhere, coupled with growing inequalities in income and wealth, have refocused attention on social class as a key determinant of population health. Routine analysis using conceptually coherent and consistent measures of socioeconomic position in US public health research and surveillance, however, remains rare. This review discusses concepts and methodologies concerning, and guidelines for measuring, social class and other aspects of socioeconomic position (e.g. income, poverty, deprivation, wealth, education). These data should be collected at the individual, household, and neighborhood level, to characterize both childhood and adult socioeconomic position; fluctuations in economic resources during these time periods also merit consideration. Guidelines for linking census-based socioeconomic measures and health data are presented, as are recommendations for analyses involving social class, race/ethnicity, and gender. Suggestions for research on socioeconomic measures are provided, to aid monitoring steps toward social equity in health.

Adult↗

PubMed2004

The influence of factors identified in adolescence and early adulthood on social class inequities of musculoskeletal disorders at age 30: a prospective population-based cohort study.

BACKGROUND: Social class inequities have been observed for most measures of health. A greater understanding of the relative importance of different explanations is required. In this prospective population-based cohort study we explored the contribution of factors, ascertained at different stages between adolescence and early adulthood, to social class inequities in musculoskeletal disorders (MSD) at age 30. METHODS: We used data from 547 men and 497 women from a town in north Sweden who were baseline examined at age 16 and followed up to age 30. Using logistic regression models, we estimated the unadjusted odds ratios (OR) for MSD for blue-collar versus white-collar workers in men and women separately. We assessed the contribution of different factors identified between adolescence and early adulthood by comparing the unadjusted OR for social class differences with OR adjusted for these explanatory factors. RESULTS: We found significant class differences at age 30 with higher MSD among blue-collar workers (OR = 2.03 in men [95% CI: 1.42, 2.90] and 1.98 in women [95% CI: 1.29, 3.02]). After adjustment for explanatory factors, class differences decreased and were no longer significant, with OR of 1.20 in men (95% CI: 0.76, 1.95) and 1.18 in women (95% CI: 0.69, 2.03). School grades at age 16; being single and alcohol consumption at age 21; having children, restricted financial resources, physical activity, alcohol consumption, smoking, and working conditions at age 30 were important for men; parents' social class, school grade, smoking and physical activity at age 16; being single at age 21; and working conditions at age 30 were important for women. CONCLUSION: The accumulation of adverse behavioural and social circumstances from adolescence to early adulthood may be an explanation for the class differences in MSD at age 30. Interventions aimed at reducing health inequities need to consider exploratory factors identified at early and later stages in life, also including structural determinants of health.

Adolescent↗

PubMed2000

Medical schools, affirmative action, and the neglected role of social class.

Medical schools' affirmative action policies traditionally focus on race and give relatively little consideration to applicants' socioeconomic status or "social class." However, recent challenges to affirmative action have raised the prospect of using social class, instead of race, as the basis for preferential admissions decisions in an effort to maintain or increase student diversity. This article reviews the evidence for class-based affirmative action in medicine and concludes that it might be an effective supplement to, rather than a replacement for, race-based affirmative action. The authors consider the research literature on (1) medical students' socioeconomic background, (2) the impact of social class on medical treatment and physician-patient communication, and (3) correlations between physicians' socioeconomic origins and their service patterns to the disadvantaged. They also reference sociological literature on distinctions between race and class and Americans' discomfort with "social class."

Humans↗

PubMed2001

Social class difference in catch up growth in a national British cohort.

AIM: To examine the influence of socioeconomic status on growth pattern in height from age 7 to 23 years. METHODS: Prospective cohort study. A total of 10 200 white singleton born children from the 1958 British birth cohort (National Child Development Study) were analysed. RESULTS: Differences in height by birth weight persisted throughout the follow up period. However, the mean differences in height between low birth weight infants (<2500 g) and adequate birth weight infants (>/=2500 g) were less notable in social classes I and II than in the lower social classes. The catching up of growth in height of low birth weight infants was also more pronounced in social classes I and II than in other social classes. That is, the mean height deficits of low birth weight infants were decreased from 2.9 cm at age 7, to 1.6 cm at age 16, and 2.5 cm at age 23; the significant difference disappeared after age 16 in social classes I and II. Although such improving tendency was more pronounced among the preterm born infants, a similar growth pattern was observed among the term infants. Such improvement was not observed in the other social classes. CONCLUSION: The growth retardation in height by birth weight can be overcome by improved social conditions and proper health care from childhood to adulthood.

Adolescent↗

PubMed2000

Social class and self-rated health: can the gradient be explained by differences in life style or work environment?

The purpose of the present paper is to describe differences in work environment and life style factors between social classes in Denmark and to investigate to what extent these factors can explain social class differences with regard to changes in self-rated health (SRH) over a 5 year period. We used data from a prospective study of a random sample of 5001 Danish employees, 18-59 years of age, interviewed at baseline in 1990 and again in 1995. At baseline we found higher prevalence in the lower classes of repetitive work, low skill discretion, low influence at work, high job insecurity, and ergonomic, physical, chemical, and climatic exposures. High psychological demands and conflicts at work were more prevalent in the higher classes. With regard to life style factors, we found more obese people and more smokers among the lower classes. The proportion with poor SRH increased with decreasing social class at baseline. The follow-up analyses showed a clear association between social class and worsening of SRH: The lower the social class, the higher the proportion with deterioration of SRH. There was no social gradient with regard to improved SRH over time. Approximately two thirds of the social gradient with regard to worsening of SRH could be explained by the work environment and life style factors. The largest contribution came from the work environment factors.

Adolescent↗

PubMed2000

Social class of origin and cardinal symptoms of schizophrenic disorders over the early illness course.

BACKGROUND: This study describes the relationship of social class of origin to cardinal symptoms of schizophrenic disorders over the early illness course. METHOD: The sample of subjects was drawn from the Suffolk County Mental Health Project, a longitudinal epidemiologic study of first-hospitalized subjects with psychotic disorders; the present study focused on patients with schizophrenic disorders. At baseline, subjects were dichotomized into upper/middle and lower social class of origin groups, based on occupation of the head of the household of origin. The patients in both groups were assessed for the major symptoms of schizophrenic disorders using standard structured instruments at both baseline and 6-month follow-up. The 6-month symptom severity levels were compared between the groups, controlling for baseline symptom status and potential confounders. RESULTS: At 6-month follow-up, the upper/middle social class of origin group, as compared to the lower social class of origin group, had lower symptom levels for hallucinations (adjusted OR = 4.88, chi2 = 8.49, P = 0.004) and delusions (adjusted OR = 2.46, chi2 = 4.16, P = 0.04). There were no notable group differences for any of the negative or thought disorganization symptoms. CONCLUSIONS: Social class of origin is associated with positive symptoms of schizophrenia over the early illness course.

Adult↗

PubMed2006

Effect of age on the relationship of occupational social class with prevalence of modifiable cardiovascular risk factors and cardiovascular diseases. A population-based cross-sectional study from European Prospective Investigation into Cancer - Norfolk (EPIC-Norfolk).

BACKGROUND: Previous studies on cardiovascular risk profile in different socioeconomic status were focused on younger populations and many of them have not been able to take into account age and sex differences. OBJECTIVES: To investigate the relationship of occupational social class with the prevalence of cardiovascular disease risk factors and cardiovascular diseases in younger (<65 years) and older (>or=65 years) men and women. METHODS: A population-based-cross sectional study was conducted in a general community in Norfolk, United Kingdom. Participants were 23,085 men and women aged 40-79 years, recruited from general practice age-sex registers as part of European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk). The prevalence of cardiovascular risk factors and cardiovascular diseases were examined. RESULTS: The prevalence of smoking was significantly higher in those in manual social classes particularly in the younger (<65) age group. Younger women in manual social classes were more likely to be smokers compared to older women in the same social class. Being in manual social classes was associated with higher cholesterol levels in women but lower cholesterol levels in men. Manual social class was associated with higher physical activity in those younger than 65 years but this association was reversed in those 65 years or older. CONCLUSION: Occupational social class is differently related to cardiovascular risk factors in individuals depending on their age and sex. This may reflect differences in behavior at work and leisure, which vary by sex and pre- and postretirement. Interventions to promote health and reduce social inequalities need to take age and gender into account.

Age Factors↗

PubMed1981

Social class and coronary heart disease.

Over the past 40 years in England and Wales the rise in mortality from coronary heart disease has continued unabated among working-class men, whereas among professional men the rate has changed little for the past 20 years. As a result it is now 26 per cent higher in social class V compared with social class I. The difference in women is larger (+ 152%), and it has been present for at least 40 years. The social class gradient for men was confirmed in a survey of 17530 London civil servants aged between 40 and 64 (the Whitehall Study). When men in the lowest employment grade were compared with those in the top (administrative) grade, the age-adjusted prevalence rate was 53 per cent higher for angina, 77 per cent higher for ischaemic-type electrocardiographic abnormalities, and 75 per cent higher for the prevalence of electrocardiographic abnormality among men with angina. At follow-up, the seven-and-a-half year coronary mortality was 3.6 times higher in the lowest than in the top grade. This social class difference was partly explained by known coronary risk factors: men in the lower grades smoked more and exercised less, they were shorter and more overweight, and they had higher blood pressures and lower levels of glucose tolerance. Most of the difference, however, remains unexplained. It seems that there are major risk factors yet to be identified, and that these may throw light on how it is possible for members of a highly-placed social group to have a relatively low risk of coronary heart disease.

Adult↗

PubMed1997

Is a child's risk of early onset schizophrenia increased in the highest social class?

In a sample from the unselected, general population Northern Finland 1966 Birth Cohort, 11017 individuals alive at the age of 16 years were studied until the age of 27. The cumulative incidence of early onset schizophrenia until 23 years was higher (1.14%; 9/792) among young persons from the highest social class or class I (determined according to father's occupation) than among children from lower social classes (0.47%; 48/10225), the difference being statistically significant (p < 0.05). The incidence of schizophrenia in the highest social class was higher than expected among girls, firstborns, children of young mothers under 30 and urban residents (p < 0.05) compared with lower social classes. When cases from the highest and other social classes were compared, there was no clear difference in background factors or clinical course. Four alcoholics, one of them also schizophrenic, were found among nine social class I fathers. The results suggest that in some families in Northern Finland, a father's professional advancement, often linked to mental disorder, may be one determinant of an increased risk of schizophrenia in the child.

Adolescent↗

PubMed2004

Social class, race/ethnicity and all-cause mortality in the US: longitudinal results from the 1986-1994 National Health Interview Survey.

BACKGROUND: Occupational social class has become a leading indicator of social inequalities in health. In the US, economic sectors are distinct with respect to wages, benefits, job security, promotion ladders and working conditions. The growing economic sector of self-employed workers is characterized by lower wages and benefits, and greater job insecurity. Little attention has been given to the association between economic sector measures of social class and all-cause mortality, and there have been no studies of mortality among the self-employed. METHODS: To determine risk of death associated with economic sector social class, this study entails a longitudinal analysis of the National Health Interview Survey (NHIS), an annual household survey representative of the US population for the period 1986-1994 (n = 377,129). The sample includes 201,566 men and 175,563 women, aged 24-65 years of age, in the civilian labor force. RESULTS: Non- professionals are at higher risk of death than professionals across all sectors and self-employed professionals are at higher risk of death than professionals employed in government and production. Additional social class differences are accounted for by age, race, gender and marital status. Results are also partially explained by income. After controlling for income, Black professionals did not show a lower risk of death than Black non-professionals and self-employed Hispanic professionals had a higher risk of death than Hispanic professionals employed in the private sector. CONCLUSIONS: Given the growth of self-employment in the US, the noted increased risk of death among self-employed professionals merits further investigation and monitoring.

Adult↗

PubMed2006

Social class is an important and independent prognostic factor of breast cancer mortality.

Reasons of the important impact of socioeconomic status on breast cancer prognosis are far from established. This study aims to evaluate and explain the social disparities in breast cancer survival in the Swiss canton of Geneva, where healthcare costs and life expectancy are among the highest in the world. This population-based study included all 3,920 female residents of Geneva, who were diagnosed with invasive breast cancer before the age of 70 years between 1980 and 2000. Patients were divided into 4 socioeconomic groups, according to the woman's last occupation. We used Cox multivariate regression analysis to identify reasons for the socioeconomic inequalities in breast cancer survival. Compared to patients of high social class, those of low social class had an increased risk (unadjusted hazard ratio [HR] 2.4, 95% CI: 1.6-3.5) of dying as a result of breast cancer. These women were more often foreigners, less frequently had screen-detected cancer and were at more advanced stage at diagnosis. They less frequently underwent breast-conserving surgery, hormonal therapy, and chemotherapy, in particular, in case of axillary lymph node involvement. When adjusting for all these factors, patients of low social class still had a significantly increased risk of dying of breast cancer (HR 1.8, 95% CI: 1.2-2.6). Overmortality linked to low SES is only partly explained by delayed diagnosis, unfavorable tumor characteristics and suboptimal treatments. Other factors, not measured in this study, also could play a role. While waiting for the outcome of other researches, we should consider socioeconomic status as an independent prognostic factor and provide intensified support and surveillance to women of low social class.

Breast Neoplasms↗

PubMed2006

Dental health differences by social class in home-dwelling seniors of Barcelona, Spain.

BACKGROUND: The aim of this study was to assess dental health differences by social class in home-dwelling seniors in Spain. METHODS: A cross-sectional household survey of a cohort of senior residents in Barcelona (Spain) was undertaken. Of 891 survivors (72 years or older), 561 (62.9%) oral examinations were completed according to the DMF Index (Decayed, Missing and Filled teeth). RESULTS: 42% of participants were edentate. The individuals of social class IV-V were more likely to be edentate, and to have fewer than 15 teeth compared to those in social class I-II. The DMF Index in dentate individuals (Adjusted mean=16.4) also showed significantly worse dental health for lower social classes (p = 0.001). CONCLUSIONS: The results of this study indicate a different level of utilization of dental health services and dental health by social class in home-dwelling seniors. Further research is needed to understand the barriers of access and social inequality.

Age Factors↗

PubMed1992

Social class, marital status, and cancer of the uterine cervix in England and Wales, 1950-1983.

STUDY OBJECTIVE: The aim was to investigate whether trends in mortality from cancer of the cervix uteri by age, marital status, and social class are compatible with current beliefs about the epidemiology of the disease. DESIGN: Data on mortality from cancer of the cervix for single and married women by age and social class were obtained from the Registrar General's Decennial Supplements on occupational mortality for the years 1950-53, 1959-63, 1970-72, and 1979, 1980, 1982, and 1983. Age standardised mortality rates were calculated directly by social class and marital status. SETTING: The data relate to all cases of carcinoma of the cervix reported in England and Wales in the years studied. MAIN RESULTS: There was a marked convergence of mortality between single and married women over the period within every social class grouping examined. The social class differential, however, remained essentially unchanged for both single and married women considered separately. CONCLUSIONS: Trends in mortality by marital status appear to reflect accurately the changes in the pattern of marriage and sexual behaviour that have taken place in the post-war period, whereas the patterns of other risk and protective factors such as screening explain these trends less well. In contrast, it seems likely that factors other than patterns of sexual behaviour and screening operate to maintain the social class differential in England and Wales.

Adolescent↗

PubMed2007

Race/ethnicity, social class, and leisure-time physical inactivity.

PURPOSE: The aims of this study were to determine 1) prevalence of leisure-time physical inactivity in a nationally representative sample of non-Hispanic white, non-Hispanic black, and Hispanic men and women; 2) prevalence of leisure-time inactivity by racial/ethnic group across social class indicators; and 3) the relationship between leisure-time inactivity and occupational physical activity, independent of other social class indicators. METHODS: The National Physical Activity and Weight Loss Survey was a telephone survey of noninstitutionalized U.S. adults (4695 men, 6516 women) conducted by random digit dialing between September and December 2002. Self-reported physical activity was assessed using questions from the 2001 Behavioral Risk Factor Surveillance System. Respondents who reported no moderate- or vigorous-intensity physical activity during leisure time in a usual week were classified as inactive. Indicators of social class were education, family income, employment status, and marital status. RESULTS: Age-adjusted prevalence of leisure-time inactivity was 9.9% +/- 0.6 SE (standard error) and 12.0 +/- 0.6 for white men and women, respectively; 19.0 +/- 2.5 and 25.2 +/- 2.1 for non-Hispanic black men and women, and 20.9 +/- 2.1 and 27.3 +/- 2.5 for Hispanic men and women. Within each racial/ethnic group, prevalence of leisure-time inactivity was highest among participants of lower social class. Differences in inactivity by racial/ethnic group were less evident after adjustment for social class. Odds of inactivity were similar across quartiles of occupational physical activity after adjustment for age, sex, and social class. CONCLUSIONS: Non-Hispanic blacks and Hispanics were more inactive during their leisure time than were non-Hispanic whites. Social class but not occupational physical activity seems to moderate the relationship between race/ethnicity and leisure-time physical inactivity.

Adolescent↗

PubMed2002

Social class mortality differences in Maori and non-Maori men aged 15-64 during the last two decades.

AIMS: This investigation uses data from 1996-97 to update previous studies of social class mortality differences in Maori and non-Maori New Zealand men aged 15-64 years. METHODS: Numerator data were obtained from the national death registrations and denominator data were from the 1976, 1986 and 1996 censi. For each social class, age standardised death rates in Maori and non-Maori men were calculated for amenable, non-amenable and all causes of mortality. RESULTS: Maori male mortality was significantly higher than non-Maori mortality in each social class and for the total population for amenable (overall RR = 5.3(CI = 4.0-6.9)), non-amenable (overall RR = 2.4(2.2-2.6)) and all causes of mortality (overall RR = 2.4(2.3-2.6)). The social class mortality differences within Maori (relative index of inequality was 3.3) were markedly greater than non-Maori class differences (RII = 1.5). CONCLUSIONS: The persistently high Maori mortality rates, when controlled for social class, indicate that the poor state of Maori health cannot be explained solely by relative socioeconomic disadvantage. The high Maori rate of potentially preventable deaths indicates that the health sector is still not meeting the serious health needs of many Maori. The social class mortality gradient within Maori underlines the need to address disparities within Maori.

Adolescent↗

PubMed1996

Current patterns and trends in male mortality by social class (based on occupation).

Every ten years, information from the decennial census is used together with national death registration data to study socio-economic differences in mortality. This article reports the findings of one of the analyses prepared for the latest decennial supplement. This volume is due for publication late in 1997. Over 175,000 deaths of men aged 20-64 in England and Wales were analysed using the Registrar General's Social Class (based on occupation) schema. The social gradient in all-cause mortality observed in earlier decades is still seen in 1991-93. In absolute terms, there has been a fall in mortality rates in England and Wales over the twenty-year period 1970-72 to 1991-93. This is reflected in the falls in mortality rates for each of the social classes I to IV over the two decades. In contrast, the mortality rate of Social Class V rose in the early 1980s. Since then, it has fallen. However, it is still higher than in the early 1970s. Trends in mortality show a relative widening of social differentials developing over this period. This is true for all-cause mortality and for the specific causes investigated in this article. Mortality is almost three times higher in Social Class V (SMR 189) than in Social Class I (SMR 66). Classes IIIM and IV (SMRs 117, 116 respectively) have nearly double the mortality of Class I. Even larger differentials are observed for stroke, lung cancer and suicide.

Adult↗

PubMed1991

Social class as a risk factor for infant mortality in an Australian population.

Studies in other countries have identified social class as a risk factor for infant mortality. In Australia there is no systematic collection of population data by social class, partly due to the absence of a recognized measure. The use of occupational prestige as an indicator of social class is discussed and Australian prestige scales reviewed. In a population based study, logistic regression analysis of infant mortality in an Australian (NSW) population shows the effects of social class on infant mortality which remain when maternal age, marital status and parity are controlled.

Australia↗

PubMed1997

Environmental exposure, social class, and cancer risk.

Exposure to a variety of environmental factors associated with cancer occurrence varies by social class. These factors include air pollutants (SO2, NO2, total suspended particulates, etc.), toxic waste hazards, and ionizing and other radiation. Heavy environmental pollution has been associated with an increased risk of some cancers and in particular lung cancer. There is limited evidence suggesting that individuals from lower social classes are exposed to higher levels of environmental pollutants than are individuals from higher social classes. This may be due to the placement of new sources of pollution or of toxic processes in disadvantaged areas, or to the selective migration of the poorer sectors of society to these areas. The available data do not allow any conclusion on the possible contribution of exposure to environmental pollution to social class differences in cancer occurrence. Exposure to ultraviolet (UV) radiation, principally from sunlight, is modified strongly by personal behaviours such as choice of recreation and use of protective clothing. Those in outdoor occupations are likely to receive the highest cumulative exposure to UV radiation. There is no clear evidence from recent survey research in Australia and North America that socioeconomic factors are strongly related to non-occupational exposure to UV radiation. Information is lacking on the influence of socioeconomic status on sun exposure in other parts of the world. There is little information on the social distribution of exposure to ionizing radiation.

Adolescent↗