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PubMed2002

Caries prevalence and patterns and their relationship to social class, infant feeding and oral hygiene in 4-5-year-old children in Amman, Jordan.

OBJECTIVES: To investigate the relationship between social class, infant feeding, oral hygiene, and prevalence and patterns of caries in 4-5-year-old Jordanian children. METHOD: Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman, Jordan. Clinical examinations were carried out by one examiner. Mothers completed questionnaires relating to social class, infant feeding and the oral hygiene habits of the children. RESULTS: Sixty-seven per cent of the children had caries; 30% had the more extensive pattern involving molars and incisors. When the significant variables were taken into account, age, social class, sleeping with the mother, use of comforter and confectionery at bed/night time were shown to be independent risk factors for caries experience. Bottle-feeding at nap/bed/night time was associated with caries in incisors and caries in incisors and/or canines. Never being breast-fed, being breast-fed for more than 18 months, being breast-fed at nap/bed/night time showed a negative association with caries confined to molars although this showed a positive association with the more extensive pattern of the disease. CONCLUSIONS: Education for mothers about appropriate breast and bottle-feeding practices should be considered in health promotion strategies.

Bottle Feeding↗
PubMed1998

Arrest among psychotic inpatients: assessing the relationship to diagnosis, gender, number of admissions, and social class.

The present study of psychotic patients investigates the relationship of specific psychotic diagnoses (i.e., psychoactive-substance-induced psychosis, schizophrenia, bipolar disorder, other DSM-III Axis I psychotic disorders), social class, gender, and number of admissions to the rate of arrest in the community. All admissions with psychotic symptoms to hospitals providing inpatient psychiatric services in the Baltimore area were surveyed during a 6-year period. Study participants were assessed using a modified version of the Diagnostic Interview Schedule. During the course of the interview, patients were asked whether they had ever been arrested as a juvenile or as an adult. After adjusting for age, gender, number of admissions, and social class, we found that patients admitted for psychoactive-substance-induced psychosis were more likely to report having been arrested than patients with other psychotic diagnoses. Patients with schizophrenia were not more likely to have an history of arrest than patients with other psychotic disorders. Number of admissions and social class were independent predictors of history of arrest. The relationship between psychotic diagnosis and history of arrest was modified by gender. Psychotic patients with substance-induced diagnosis who were male were more likely to report a prior arrest in the community than their female counterparts. Our results suggest that type of psychotic diagnosis and social class, in addition to gender and number of admissions, are important predictors of differences in arrest-rate histories among psychotic patients. Gender appears to be an effect modifier of the relationship between psychotic diagnosis and history of arrest.

Adolescent↗
PubMed2003

Evaluation of association between retention in the home and attendance at puppy socialization classes.

OBJECTIVE: To evaluate associations between retention of dogs in their adoptive homes and attendance at puppy socialization classes and other factors. DESIGN: Epidemiologic survey. ANIMALS: 248 adult dogs that were adopted as puppies from a humane society. PROCEDURE: Owners completed questionnaires regarding demographics, retention of the dogs in the homes, and the dogs' early learning events. RESULTS: Higher retention in the homes was reported for dogs that participated in humane society puppy socialization classes, were female, wore headcollars as puppies, were handled frequently as puppies, were more responsive to commands, slept on or near the owner's bed, or lived in homes without young children. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest several practices that veterinarians may recommend to enhance the likelihood that puppies will remain in their first homes, such as enrolling 7- to 12-week-old puppies in early learning and socialization classes. The lower rate of retention of dogs in homes with children emphasizes the importance of helping owners develop realistic expectations, knowledge, and effective tools to manage interactions between their children and dogs.

Aging↗
PubMed1984

Sexual maturation, social class, and the desire to be thin among adolescent females.

Veblen's 1899 hypothesis that associated a female desire for thinness with the higher social classes was tested with data from a representative national sample of adolescents, 12 to 17 years of age, in the National Health Examination Survey. Controlling for the actual level of fatness, adolescent females in higher social classes wanted to be thinner more often than those in lower classes. The greater female desire for thinness was not the product of health information nor of sex differences in the level of fatness. The thinner the female, the greater the impact of social class on the desire for thinness. During puberty, adolescent females negatively evaluated the body fat associated with normal sexual development.

Adolescent↗
PubMed1982

Social class and age at diagnosis of Hodgkin's disease: new epidemiologic evidence for the "two-disease hypothesis".

The bimodality in the age-incidence pattern of Hodgkin's disease (HD) suggests that the disease may result from two causal pathways with differing age peaks. Among young adults, HD may develop as a rare consequence of a common infection (probably viral), with risk increasing with age at time of infection. However, among older persons, HD may result from other causes, probably similar to those of the other lymphomas. We evaluated this hypothesis in a population-based, case-control study in eastern Massachusetts involving 326 newly diagnosed cases (patients greater than or equal to 15 years of age) and 650 population controls. These subjects were compared for factors in childhood environment that influence age of exposure to common viruses, including sibship size, parental education, and type of housing. Among young adults (15-39 years of age), risk of HD was associated with small family size, single-family housing, and relatively high maternal education, consistent with the delayed infectious exposure hypothesis. Among middle-aged persons (40-54 years of age), a similar pattern of social class risk factors was present. However, among older persons (greater than or equal to 55 years of age), risk was not associated with social class; if anything, patients were of somewhat lower social class background than controls. These findings are consistent with the "two-disease hypothesis," in that social class risk factors differed between younger and older persons. These findings, coupled with other epidemiologic observations, suggest that the pathogenesis of HD among older persons is independent of that among younger persons.

Adolescent↗
PubMed1993

Diagnostic delay, clinical stage, and social class: a hospital based study.

STUDY OBJECTIVE: To measure delay in admission to a large hospital and to study the role of social class and other potential determinants of delay. DESIGN: Interview of a 10% sample of newly diagnosed patients admitted to medical or surgical wards, and all those admitted for external hernia or colon cancer between June 1989 and May 1990. SETTING: The largest hospital in an Italian region of five million inhabitants. SUBJECTS: The study population consisted of 330 patients with a range of different medical and surgical conditions, 83 patients with external hernias, and 97 patients with colon cancers. MEASUREMENTS AND MAIN RESULTS: After patient interview and discharge from hospital, the clinical record was consulted for information on the length of stay and the diagnosis, and in particular for the staging of hernia or colon cancer (according to the protocol of the Jefferson Medical College). Multiple logistic regression was used to estimate odds ratios and 95% confidence intervals. There was an association between advanced disease at hospital admission and the patient's educational level. In each of the three groups of patients, those with the highest educational level had a 30% or lower probability of being admitted to hospital with advanced disease compared with those with the lowest education level (after allowance for sex, age, area of residence, and marital status). CONCLUSION: Lower social class was associated with a more advanced clinical stage of hernia or colon cancer, and with a higher probability of urgent admission to the hospital for a newly diagnosed disease. Delay in seeking care, did not however, seem to explain the social class differentials for disease stage.

Adult↗
PubMed1986

Perinatal outcomes and related factors: social class differences within and between geographical areas.

This paper makes use of the opportunity provided by comparable obstetric data bases to examine area and social class variations in perinatal outcome and associated factors in areas smaller than those usually reported. Analyses are based on singleton births to primiparous residents in the catchment areas of the Aberdeen Maternity and Neonatal Database (n = 4948) and the Cardiff Births Survey (n = 11893) between 1976 and 1981. The factors considered relate to the obstetric population (height, age, and smoking), obstetric practice (induction and assisted delivery), and perinatal outcome (curtailed gestation, low birthweight, and perinatal death). Our analysis confirms the existence of both area and social class differences and suggests that, except in the case of teenage pregnancy and smoking, the association observed between those factors and area and social class are largely independent of each other.

Female↗
PubMed1997

Incidence of health of the nation cancers by social class.

Using data from the Longitudinal Study social class patterns in the incidence of breast, lung and cervical cancer in women, and lung cancer in men, for the period 1976-89 were examined. At working ages, 15 to 64, there was very little difference in breast cancer incidence between women in non-manual and manual classes. At older ages the incidence was higher in women in non-manual classes than in those in manual classes. Cervical cancer incidence was considerably higher among younger women in manual than in non-manual classes and these differences were greatest in 1986-89. Among both younger and older men and women, strong class differentials in the incidence of lung cancer were evident in 1986-89. These findings indicate the need to target prevention strategies sensitively and to ensure equitable access to services.

Adolescent↗
PubMed1981

Physical activity at work and at leisure in relation to coronary risk factors and social class. A 4-year mortality follow-up. The Oslo study.

The association between physical activity at work and at leisure, coronary risk factors, social class and mortality has been studied in about 15000 Oslo men, aged 40-49, without known cardiovascular disease or diabetes at a screening examination for coronary risk factors. Four-year total and CHD mortality showed a decrease with increasing degree of leisure activity, and an increase with increasing work activity. The three conventional coronary risk factors--serum cholesterol, systolic blood pressure (SBP) and number of cigarettes--associated negatively with physical leisure activity, whereas they all associated positively with physical activity at work. Men in lower social classes were less active at leisure but more active at work than men in the higher classes. In a multivariate analysis of variance with coronary risk score (based on SBP, serum total cholesterol and number of cigarettes), social class and physical activity, the predictive power of physical leisure activity for future death was almost as good as the coronary risk score. Physical activity at work, on the other hand, was not an independent risk factor either for total or for CHD mortality.

Adult↗
PubMed2001

Social class differences in lung cancer mortality: risk factor explanations using two Scottish cohort studies.

BACKGROUND: The study investigated differences in lung cancer mortality risk between social classes. METHODS: Twenty years of mortality follow-up were analysed in 7052 men and 8354 women from the Renfrew/Paisley general population study and 4021 working men from the Collaborative study. RESULTS: More manual than non-manual men and women smoked, reported morning phlegm, had worse lung function and lived in more deprived areas. Lung cancer mortality rates were higher in manual than non-manual men and women. Significantly higher lung cancer mortality risks were seen for manual compared to non-manual workers when adjusting for age only and adjustment for smoking reduced these risks to 1.41 (95% CI : 1.12-1.77) for men in the Renfrew/Paisley study, 1.28 (95% CI : 0.94-1.75) for women in the Renfrew/Paisley study and 1.43 (95% CI : 1.02-2.01) for men in the Collaborative study. Adjustment for lung function, phlegm and deprivation category attenuated the risks which were of borderline significance for men in the Renfrew/Paisley study and non significant for women in the Renfrew/Paisley study and men in the Collaborative study. Adding extra socioeconomic variables, available in the Collaborative study only, reduced the difference between the manual and non-manual social classes completely. CONCLUSIONS: There is a difference in lung cancer risk between social classes, in addition to the effect of smoking. This can be explained by poor lung health, deprivation and poor socioeconomic conditions throughout life. As well as anti-smoking measures, reducing socioeconomic inequalities and targeting individuals with poor lung function for help with smoking cessation could help reduce future lung cancer incidence and mortality.

Chi-Square Distribution↗
PubMed2000

Social class differences in mortality using the new UK National Statistics Socio-Economic Classification.

Social class differences in health in the UK have usually been demonstrated by the Registrar General's social classification (RGSC). It is being replaced by the new UK National Statistics Socio-Economic Classification (NS-SEC). The NS-SEC is explicitly based on differences between employment relations and conditions. The mechanisms underlying social class differences in health remain debatable. Some studies have hypothesised that class differences in work characteristics and employment conditions may explain part of the observed class differences in health. This study investigates the associations of the NS-SEC and other measures of socio-economic status (SES) with mortality outcomes in a 7-year panel study representative of British private households and their members (the British Household Panel Survey, n = 10264). The NS-SEC was neither significantly associated with mortality for respondents of all ages nor with mortality for a younger subsample who were under 65 years at the initial survey. Other measures of SES, especially income and housing tenure showed significant patterns of inequalities in mortality. It may be useful to use other measures of SES along with the NS-SEC when analysing social inequalities in health and mortality.

Adult↗
PubMed2003

Social class and semen analysis.

It has often been postulated that certain occupations may be hazardous to semen counts, but there are many conflicting views, with others finding either no differences in sperm count or only subtle differences in semen variables. We studied the effect of occupation (in relation to social class) on 207 men attending the fertility clinic of a district general hospital. In our own population azoospermic men were more likely to be of social class 3 m (3 semi-skilled manual) and below. Men who failed to provide a sample were more likely to be of social class 3 m. There was no statistical occupation difference in men whose sperm counts were normal or low. It may not be occupation alone, but also lifestyle differences between social classes which affect semen parameters.

Adult↗
PubMed2006

Social class, education, and smoking cessation: Long-term follow-up of patients treated at a smoking cessation unit.

Our objective was to examine social class and educational differences in long-term smoking cessation success among a cohort of smokers attending a specialized smoking clinic. We studied sustained abstinence after cessation among 1,516 smokers (895 men and 621 women) treated for smoking cessation between 1995 and 2001 at a university teaching hospital in the metropolitan area of Barcelona, Spain. We calculated 1-year and long-term (up to 8-year) abstinence probabilities by means of Kaplan-Meier curves and the hazard ratio of relapse by means of Cox regression, after adjusting for other predictors of relapse. Overall abstinence probability was .277 (95% CI = .254-.301). Men and women in social classes IV-V had significant hazard ratios of relapse after long-term follow-up (men: 1.36, 95% CI = 1.07-1.72; women: 1.60, 95% CI = 1.24-2.06), as compared with patients in social classes I-II. The same independent effect was observed for education: Men and women with primary or less than primary studies had higher hazard ratios of relapse (men: 1.75, 95% CI = 1.35-2.25; women: 1.92, 95% CI = 1.51-2.46), as compared with patients with a university degree. Similar estimates were obtained after adjustment for stage of change, Fagerström score for nicotine dependence, and type of treatment. Patients of lower socioeconomic status are at higher risk of relapse, and this association is independent of other well-known predictors of relapse. Social differences have to be taken into account in the clinical setting when tailoring specific actions to treat smoking dependence.

Adult↗
PubMed1997

Alcohol drinking, social class and cancer.

This chapter reviews the data on occurrence of cancers that are potentially caused by alcohol drinking (cancers of the upper gastrointestinal and respiratory tracts, and liver cancer) in relation to social class. In order to assess the role of alcohol drinking in the observed social class gradients of these cancers, we have particularly looked for consistency in the gradients of different alcohol-related cancers, and used lung cancer occurrence to judge the role of tobacco smoking, which is the major other determinant of these diseases. Additional data on levels of alcohol drinking and on the occurrence of other alcohol-related morbidity are brought into the discussion where available. A role of alcohol drinking in the observed negative social class gradients for alcohol-related cancers is very likely in men in France, Italy and New Zealand. Evidence that is less strong, but is suggestive of a role of alcohol drinking, is seen for men in Brazil, Switzerland, the United Kingdom and Denmark. Although a role of alcohol drinking is likely or possible in certain populations, other factors may contribute as well, most notably tobacco smoking and dietary habits. Additional data on the frequency of complications after surgical procedures in alcohol drinkers are reviewed briefly.

Alcohol Drinking↗
PubMed1980

Differences between the lower social classes: some new trends.

From a four-year sample of 7407 patients, this study sought to determine whether characteristics of patients in Social Class IV are closer to those of Class V, as frequently assumed, or more similar to those of Class III. The implications of social class differences for newer forms of treatment, and newly emerging types of therapists, were also examined. Results suggest that Classes IV and V should be considered separately for both research and clinical planning purposes.

Humans↗
PubMed1996

[Differences between proposals for implementation of the social class concept in epidemiological studies]

This article compares different proposals for the implementation of the concept of social class and analyzes the alternatives used in each proposal, considering previous epidemiological studies on this issue and the potential of such a concept as a central category in studies on social determination in the health/disease process. Seven basic differences were identified, pertaining to the following aspects: class structure; research objective; the social class concept as a reference; the decision as to which individual has his/her occupational activity taken as defining the family's social class; the class status of the unemployed, housewives, and the retired; class status of students; and criteria for distinguishing between the "bourgeoisie", "petty bourgeoisie", "new petty bourgeoisie", and "proletariat" and whether there is a specific flow in certain population groups. Given the observed differences and underlying theoretical models, this study discusses problems related to the fact that the use of a specific concept of social class can have various implementation models.

Journal Article↗
PubMed2004

Unemployment and mental health: understanding the interactions among gender, family roles, and social class.

OBJECTIVES: We examined gender differences in the effects of unemployment on mental health and assessed whether such effects are associated with interactions among gender, family roles, and social class. METHODS: Our analysis included 3881 employed and 638 unemployed workers, aged 25 to 64 years, interviewed in the 1994 Catalonian Health Survey. RESULTS: Unemployment had more of an effect on the mental health of men (age-adjusted odds ratio [OR] = 2.98; 95% confidence interval [CI] = 2.30, 3.87) than on that of women (age-adjusted OR = 1.51; 95% CI = 1.11, 2.06). Gender differences in effects were related to family responsibilities and social class. CONCLUSIONS: Understanding the effects of unemployment on mental health requires consideration of the interactions among gender, family responsibilities, and social class.

Adult↗
PubMedDate not supplied

Phenomenology of delusions in Pakistani patients: effect of gender and social class.

The present study aimed to assess the actual content of delusions of Pakistani schizophrenic patients by gender and social class. A total of 98 schizophrenic patients (48 men and 50 women) from the two psychiatric units in Lahore, Pakistan, were interviewed using the Present State Examination categories. When the sample was analysed as a whole, the delusion of persecution was found to be the most common one followed by the delusion of grandiose identity. When the sample was divided according to gender and social class, two subgroups with surprisingly similar themes of delusions emerged from the analysis, one male and wealthy and the other female and poor. The themes of having special powers and being a star were more frequently found among the former, whereas the themes of black magic, persecution, being controlled and erotomania appeared to be more conspicuous among the latter. The results indicated that the phenomenology of delusions differs in subgroups of the population depending on their socio-cultural roles and specific vulnerabilities.

Adult↗