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PubMed1998

Health actions and social class among older Australians.

This paper aims to identify aspects of social class that are related to health actions important for older Australians. Data are from the 1994 Health Status of Older People Project baseline survey of 1,000 participants aged 65 and over in Melbourne. Analyses employed logistic regression controlling for age and gender. Physical activity was related to both former occupation and current income; social activity to former occupation; and not smoking to home ownership. Health promotion strategies require a better understanding of the ways in which aspects of social class affect the life course experiences of different birth cohorts. Promotion of physical and social activity in old age needs to take account of the continuing influence of advantages associated with social class.

Age Factors↗
PubMed1977

Hypertension: effects of social class and racial admixture: the results of a cohort study in the black population of Charleston, South Carolina.

It has been hypothesized that genetic factors, as manifested by skin color, play in important role in the genesis of hypertension among Blacks. A community-based study was carried out in Charleston Country, South Carolina to test this hypothesis. The results of a ten year follow-up study suggest that social class and age were more consistently associated with the incidence of hypertension and levels of blood pressure. The association of hypertension with skin color was minimal and substantially less than that of social class. The incidence rate of hypertension (larger than or equal to 90 mm Hg) was three to four times greater when the study participants were of low social class than when they had higher social class scores at the beginning of this study. In contrast, the incidence rate was only 1.5 times higher for dark than for lighter skinned men, and the rates were almost identical when social class was comparable. Similar results energed when blood pressure was treated as a continuous variable; blood pressure levels and pressure changes over time were consistently and significantly (p less than .01) higher in those Blacks categorized as low social class, controlling for skin color.

Adult↗
PubMed1974

Social class and marital distance in Oxford City.

A study has been made of social class distributions and their effects on marital movement in the city of Oxford from 1837 to the present day. The data have been obtained from the marriage registers of nine ecclesiastical parishes which transect the city. There is marked social class heterogeneity according to district, but when the data are combined some striking relationships between occupation and the distributions of marital distance emerge. In general distance decreases and amounts of city endogamy increase almost linearly as one moves from Class I to Class V. There appears to be, however, no very great increase in marital distance in this century as compared with the situation in the last two-thirds of the nineteenth century. Some of the differences between the social classes are due to differences in marital age, but even after this has been taken into account there remains a very statistically significant relationship between class and marital movement.

Adolescent↗
PubMed1981

The Pittsburgh Insulin Dependent Diabetes Mellitus Registry: the relationship of insulin dependent diabetes mellitus incidence to social class.

The incidence of insulin dependent diabetes mellitus, as determined from the Pittsburgh Insulin Dependent Diabetes Mellitus Registry, was examined in relationship to social class. The registry consists of all Allegheny County, Pennsylvania, cases of insulin dependent diabetes diagnosed under age 20 years in 1965-1976. Analyses of the registry data revealed little relationship between incidence, age at onset and social class. The lack of a strong relationship to social class indicates that the epidemiology of insulin dependent diabetes is not similar to those of polio or Hodgkin's disease, in which social class is strongly related to incidence and age at onset.

Adolescent↗
PubMed1992

Childhood aggression, peer status, and social class as predictors of delinquency.

Measures of aggression, peer status, and social class, gathered during the subjects' childhoods, were assessed as predictors of later delinquency for 711 boys. Multiple regression analysis indicated that aggression was the most significant predictor of delinquency followed by social class as the second significant predictor. A descriptive analysis isolated characteristics of groups varying markedly in terms of differences in rates of delinquent outcomes.

Aggression↗
PubMed2006

[The effects of the parents' social class on infant and child death among 1995-2004 birth cohort in Korea].

OBJECTIVES: To investigate the effect of parents' social class on infant and child mortality rates among the birth cohort, for the period of transition to and from the Koran economic crisis 1995-2004. METHODS: All births reported to between 1995 and 2004 (n=5,711,337) were analyzed using a Cox regression model, to study the role of the social determinants of parents in infant and child mortality. The results were adjusted for the parents' age, education and occupation, together with mother's obstetrical history. RESULTS: The crude death rate among those under 10 was 3.71 per 1000 births (21,217 deaths among 5,711,337 births) between 1995 and 2004. The birth cohorts from lower educated parents less than elementary school showed higher mortality rates compared with those from higher educated parents over university level (HR:3.0 (95% CI:2.8-3.7) for father and HR:3.4 (95% CI:3.3-4.5) for mother). The mother's education level showed a stronger relationship with mortality among the birth cohort than that of the fathers'. The gaps in infant mortality rates by parents' social class, and educational level became wider from 1995 to 2004. In particular, the breadth of the existing gap between higher and lower parents' social class groups has dramatically widened since the economic crisis of 1998. DISCUSSIONS: This study shows that social differences exist in infant and child mortality rates. Also, the gap for the infant mortality due to social class has become wider since the economic crisis of 1998.

Child↗
PubMed1977

Residential segregation in urbanized areas of the United States in 1970: an analysis of social class and racial differences.

Sociologists and urban commentators often portray metropolitan areas as highly segregated by social class and race. We measured the extent of socioeconomic residential segregation in urbanized areas of the United States in 1970, determined whether cities were as segregated as suburban rings, and compared levels of socioeconomic and racial residential segregation. We found moderate levels of residential segregation and socioeconomic groups. Levels of social class segregation varied little from one urbanized area to another and were about the same in central cities and suburban rings. Racial residentail segregation was much greater than the segregation of social classes within either the black or white communities. The extent of racial residential segregation does not vary by educational attainment, occupation, or income.

Black or African American↗
PubMedDate not supplied

Representations of race, ethnicity, and social class in case examples in The American Journal of Occupational Therapy.

OBJECTIVE: This article examines descriptors of race, ethnicity, and social class in case material in 145 articles published in The American Journal of Occupational Therapy from 1975 to 1998. METHOD: Ethnicity labels and descriptors of occupation or other indicators of social class in case examples describing adults were collected. Frequencies of these labels and descriptors were compared with the population demographics of the 1990 U.S. census using chi-square goodness-of-fit analyses. RESULTS: Reported indicators of race and social class were inconsistent and primarily absent in the literature, making comparisons with the U.S. population difficult. When missing race labels were assumed to be White, the case material showed disproportionate racial distributions compared with that of the U.S. population, with persons of minority races being significantly underrepresented. CONCLUSION: The findings suggest that appropriate representation of race and social class in occupational therapy literature has not yet been achieved. The authors suggest a change in documentation conventions for occupational therapy literature and clinical writing.

Bias↗
PubMed1994

Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in The Netherlands.

Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and easy access to medical care for all its inhabitants. Other risk factors that were taken into account were smoking, drinking, occupation, age and height. Information was collected by interview in the first 3 weeks of life of the mothers of 2027 (response 97%) live-born singletons born in the period from April 1988 to October 1989 in the study area. After adjustment for possible confounding factors very low social class, compared with high social class, was significantly associated with reduced birthweight (-4.0%; 95% CI, -7.4% to -0.7%), but not with preterm delivery (OR, 2.09; 95% CI, 0.67-6.48). The adjusted birthweight of Turkish infants (2.7%; 95% CI, -1.1% to 6.5%) and the adjusted birthweight of infants from Suriname or the Antilles (-1.6%; 95% CI, -5.5% to 2.1%) were not significantly different compared with infants of Dutch mothers. After adjustment, the frequency of preterm birth was lower in Turkish infants, but not significantly (OR, 0.22; 95% CI, 0.04-1.10), whereas the frequency of preterm birth in infants from Suriname or the Antilles was significantly higher (OR, 2.51; 95% CI, 1.04-6.08) compared with Dutch infants. Of the other factors the main risk factors were smoking (negatively related with birth-weight) and maternal age(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Clustering of risk factors and social class in childhood and adulthood in British women's heart and health study: cross sectional analysis.

OBJECTIVE: To examine co-occurrence and clustering of risk factors used in the Framingham equation by social class in childhood and adult life. DESIGN: Cross sectional study. SETTING: 23 towns across England, Wales, and Scotland. PARTICIPANTS: 2936 women aged 60-79 years. MAIN OUTCOME MEASURES: Prevalence of risk factors (hypertension, obesity, smoking, left ventricular hypertrophy on electrocardiography, diabetes, and low concentration of high density cholesterol); ratios of observed to expected frequencies of clusters of risk factors. RESULTS: Risk factors were more common in women from manual social classes in either childhood or adult life, and the co-occurrence of three or four of these risk factors was greater among more disadvantaged groups. Within the four socioeconomic groups, these risk factors occurred together more than would be expected from their individual frequency distributions, indicating that they were clustered. The extent of this clustering was similar in all four social class groups. CONCLUSIONS: Clustering of risk factors included in the Framingham risk function occurs in all social class groups, but the lack of social patterning makes it unlikely that clustering is an explanation of socioeconomic inequalities in cardiovascular disease. As the proportion of women with co-occurrence of risk factors is greatest in those from manual social class in childhood, this measure of socioeconomic position might prove useful in risk prediction.

Aged↗
PubMed2004

Ethnicity, social class and hostility: effects on in vivo beta-adrenergic receptor responsiveness.

Little is known about the potential influences of social and psychosocial variables in accounting for ethnic differences in the beta-adrenergic receptor. We examined the effects of ethnicity, social class, and other variables on an in vivo marker of beta-adrenergic receptor responsiveness (Chronotropic 25 Dose, CD(25)) for 224 African-Americans and Caucasian-Americans. Social class was determined using the clinician-rated Hollingshead two-factor index. The Cook-Medley hostility and Buss-Durkee assaultiveness subscales were administered to a subset of subjects. Results indicated that African-Americans had decreased beta-receptor responsiveness compared to Caucasian-Americans after controlling for social class, age, and smoking (P=0.001). Secondary analysis for a subset of subjects revealed significant hostility x ethnicity interactions, such that hostility predicted decreased beta-receptor responsiveness for Caucasian-Americans (P=0.004), but not for African-Americans. Thus, decreased beta-adrenergic receptor responsiveness in African-Americans does not appear to be due to differences in current social class, age, or smoking status, nor to higher reports of hostility.

Adrenergic beta-Agonists↗
PubMed1982

Social class and infantile autism.

Twenty infantile autistic children, constituting what is likely to be the majority of the total population of autistic children born in the years 1962 through 1973 and living in Göteborg, Sweden, by the end of 1978, were compared with a random population sample of 59 7-year-old Göteborg children with regard to social class. Two different social classification systems were used, one that takes account only of the father's occupation and one that includes several other parameters. The distributions of social class were almost identical in the infantile autism group and in the random group. With respect to some other social circumstances the two groups were very similar. Thus, the present results lend no support for the view that autistic children tend to come from high social classes.

Adolescent↗
PubMed1983

Social class as a prognostic variable in acute lymphoblastic leukaemia.

We studied the relationship between social class and prognosis in children with acute lymphoblastic leukaemia. Seventy children who were commencing on curative therapy, and who received central nervous system prophylaxis, were included in the study. Children from social classes 1 to 5 had a significantly better five-year survival rate and duration of first remission than children from social classes 6 and 7. There was no apparent difference either in the treatment given to the two groups or in the clinical and haematological parameters studied. A study of the causes of this difference in survival could lead to better over-all results in the treatment of childhood leukaemia.

Black or African American↗
PubMed2005

Are rich people or poor people more likely to be ill? Lay perceptions, by social class and neighbourhood, of inequalities in health.

Research in the UK has suggested that people in lower social classes or from poorer neighbourhoods are less likely than their more socially advantaged counterparts to agree that health and life expectancy are worse among more deprived population groups. The small body of previous research has either used qualitative approaches or coded open-ended responses to survey questions about causes of health and illness or of inequalities between areas. We examined lay perceptions by asking a direct question and using a quantitative, multivariate approach. Residents in three age groups (25, 45 and 65 years old) living in two socially contrasting localities in Glasgow, Scotland, were asked who were more likely to have accidents, cancer, heart disease, mental illness, to be fitter, and to live longer: rich people, poor people, or both equally. Across all the health categories, those in lower social classes or from poorer neighbourhoods were equally or less likely than their more socially advantaged counterparts to say the poor had worse health. In a model containing age, sex, class and locality, those in lower social classes and in the poorer locality were significantly less likely to say that richer people live longer (OR: 0.5). We have therefore confirmed earlier observations that those most at risk of ill health may be less likely to acknowledge the social gradient in health. We suggest a need to examine this apparent paradox in other contexts and in more detail, using both quantitative and qualitative approaches.

Accidents↗
PubMed1996

Effect of social class on the prevalence and severity of necrotising ulcerative gingivitis in Nigerian children.

A study was designed to determine the relationship of social class to the prevalence of necrotising ulcerative gingivitis (NUG) and its severity. The study cohort was made up of 438 consecutive under 12-year old children attending Dugbe Dental Centre in Ibadan, Nigeria. They were assessed by history taking and intra-oral examination using a dental probe and dental mirror. A modification of the social class criteria of Olojugba and Lenon (1987) was used to determine the social class of the children. An index was also developed for NUG severity. The prevalence of NUG in the study cohort was 27.4%. The results showed a strong association between the prevalence and severity of NUG and social class (X2 46.75 P < 0.001).

Child↗
PubMed1993

Social class gradients in years of potential life lost in Switzerland.

Analysis of the official Swiss mortality data have shown considerable social differences. In an earlier study of Swiss men aged 15-74 for the period 1979-1982 the social class mortality differentials have been analysed using standardized mortality ratios (SMR). The present study extends this previous work by calculating years of potential life lost (YPLL) before age 75, an additional indicator of mortality that puts more importance on deaths at younger ages. Emphasis is given on causes contributing to most years of life lost, especially to accidents and violent deaths, which result in more than 30% of total years of life lost. The distribution of years of life lost of the most important causes to social classes is illustrated also for age-specific groups. Additionally, this article presents all causes which account for more than 3% of total years of life lost. The social inequalities are shown as ratios between the social class with the highest (skilled manual workers) and the lowest risk (professionals). Most years of life are lost by skilled manual workers not only in general but also cause-specific. While the SMR from all causes of death showed a 2-fold difference between professionals and skilled manual workers, the social gradient in YPLL rate was even larger (2.5). Hence, the measure of years of potential life lost emphasizes the disadvantage of skilled manual workers to die earlier than professionals. The concept of YPLL proved to be a useful additional indicator not only of mortality in general, but also especially for monitoring causes, related to the lower social classes.

Adolescent↗
PubMed1992

Ischaemic heart disease incidence by social class and form of smoking: the Copenhagen Male Study--17 years' follow-up.

The Copenhagen Male Study is a prospective, cardiovascular cohort study initiated in 1970 and consisting of 5249 employed men aged 40-59 years. A total of 4710 men, who had reported their smoking habits and were free of ischaemic heart disease, had their mortality recorded over a 17-year period: 585 men suffered a first incident of ischaemic heart disease (IHD), and 248 cases were fatal. There was a strong social gradient in the risk of IHD (Kendall's Tau B = 0.12, P less than 0.001). Adjusting for age, blood pressure, physical activity, body mass index and alcohol consumption in a multiple logistic regression equation, men in the lowest social class had a relative risk (95% confidence interval) of IHD of 3.6 (2.5-5.3) compared to men in the highest social class. We determined whether differences in smoking habits could explain at least some of this large increase in risk. Adjustment for the above factors and also inclusion of the form of tobacco smoked, the amount of tobacco smoked and presence or absence of inhalation, had very little effect on the estimate: the relative risk was 3.5 (2.4-5.2). There was no social gradient in age at the start of smoking. According to smoking habits, comparing social class V with social class I, the relative risk was 7.7 (2.6-22.4) in cigarette smokers, 6.0 (1.1-32.1) in pipe smokers, 3.5 (1.7-7.1) in mixed smokers, 2.25 (0.4-12.9) in cheroot smokers, 3.8 (2.4-5.9) in all smokers, 1.95 (0.8-4.6) in ex-smokers, and 4.7 (1.01-22.2) in non-smokers. In the upper social classes, 50-75% of IHD events could be ascribed to smoking, and in the lowest classes only about 20%. We conclude that the substantial social inequalities in risk of ischaemic heart disease are not accounted for by differences in smoking habits.

Adult↗
PubMedDate not supplied

Educational achievements, employment and social class of insulin-dependent diabetics: a survey of a young adult clinic in Liverpool.

The educational achievements, current employment, and social class of 137 diabetic patients aged 20.9 +/- 3.0 years (mean +/- SD), attending a Young Adult Diabetic clinic in North Liverpool were surveyed. The duration of diabetes was 7.8 +/- 5.0 years. Patients who developed diabetes in childhood (age at diagnosis less than 13 years) were more likely to have achieved educational qualifications, be employed, and be of social class I or II than those developing diabetes aged 13-25 years. Compared with non-diabetic young adults from North Liverpool, diabetics achieved similar educational qualifications and were as likely to be employed after leaving full-time education. This is an encouraging finding in the present harsh economic climate. The clustering of social classes I and II in childhood diabetics found in this study requires a larger epidemiological study of social class and insulin-dependent diabetes for confirmation.

Adult↗