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PubMed2001

Excess incidence of squamous cell esophageal cancer among US Black men: role of social class and other risk factors.

Data from a population-based case-control study were used to evaluate the relation between social class factors and squamous cell esophageal cancer and the extent to which alcohol, tobacco, diet, and low income contribute to the higher incidence among Black men than among White men in the United States. A total of 347 male cases (119 White, 228 Black) and 1,354 male controls (743 White, 611 Black) were selected from three US geographic areas (Atlanta, Georgia, Detroit, Michigan, and New Jersey). Cases were residents of the study areas aged 30-79 years who had been diagnosed with histologically confirmed esophageal cancer between 1986 and 1989. The adjusted odds ratios for subjects with annual incomes less than $10,000 versus incomes of $25,000 or more were 4.3 (95% confidence interval: 2.1, 8.7) for Whites and 8.0 (95% confidence interval: 4.3, 15.0) for Blacks. The combination of all four major risk factors-low income, moderate/heavy alcohol intake, tobacco use, and infrequent consumption of raw fruits and vegetables-accounted for almost all of the squamous cell esophageal cancers in Whites (98%) and Blacks (99%) and for 99% of the excess incidence among Black men. Thus, lifestyle modifications, especially a lowered intake of alcoholic beverages, would markedly decrease the incidence of squamous cell esophageal cancer in both racial groups and would narrow the racial disparity in risk. Further studies on the determinants of social class may help to identify a new set of exposures for this tumor that are amenable to intervention.

Adult↗
PubMed2006

[Prevalence of tuberculosis infection and its association with social class in children in the Autonomous Community of Madrid].

INTRODUCTION: The frequency of tuberculosis infection, particularly among children, indicates the magnitude of the disease reservoir. The aim of this study was to ascertain the prevalence of tuberculosis infection in children in the Autonomous Community of Madrid and its association with social class. MATERIAL AND METHODS: We performed a cross sectional study of 6-year-old schoolchildren living in the Autonomous Community of Madrid, selected through probabilistic sampling. From September 1999 through June 2000, information was collected on residence stratum, tuberculin test (positivity threshold 5 mm), social class (five categories), based on the occupation of the main earner in the family, and the formal education attained by the parents. We calculated 95% confidence intervals for the prevalence estimates according to a Poisson distribution. RESULTS: A total of 2,721 children were studied. The prevalence of tuberculosis infection for the total study population was 0.62% (95% CI: 0.29-0.95). The prevalence of tuberculosis infection was 0.42% (95% CI: 0.00-0.85) in social class I (the highest), 0.00% (95% CI: 0.00-1.17) in class II, 0.77% (95% CI: 0.00-1.86) in class III, 0.62% (95% CI: 0.00-1.32) in class IV, and 1.57% (95% CI: 0.00-3.40) in class V (the lowest). In both fathers and mothers, the highest prevalence of tuberculosis infection was found in the group that had only completed elementary school or basic general education (up to the age of 14). CONCLUSIONS: The prevalence of tuberculosis infection in the Autonomous Community of Madrid is similar to that in others areas of Spain. The results of our study are consistent with a lower prevalence in the higher socioeconomic groups.

Child↗
PubMed1984

Social class and psychological ill-health during unemployment.

This study explores psychological health and the experience of being unemployed for between 6 and 11 months in two social class groups: unskilled and semi-skilled workers v. white-collar, managerial and professional workers. The respondents were British married men aged between 25 and 39. Information was obtained through interviews about financial and other problems, perceived threats associated with unemployment, anxiety, depression, general psychological distress and ratings of general health. It was expected that the working-class sample would exhibit poorer psychological health than the middle-class, but this was not confirmed. Medium-term unemployment appeared to have a homogenizing effect, with similarly poor health in both social class samples, although working-class respondents reported significantly greater financial problems and difficulties in filling the time.

Adult↗
PubMed1978

Mortality by marital status and social class in Finland during 1969--1971. Mortality from natural and violent causes.

In this paper a study of the distribution of mortality rates by social class and marital status for men and women in three age groups (25--44, 45--64 and 65--84) is presented. Natural and violent causes of death are analysed separately. The death certificates of Finnish citizens for the years 1969, 1970 and 1971 (totalling 137780) were analysed and mortality rates standarized using as reference population the data from the 1970 census. It is shown that certain combinations of social class and marital status can be considered as significant risk factors for mortality in the Finnish population.

Adult↗
PubMed1994

Can social class differentials in hypertension be explained by the general susceptibility hypothesis?

In a population-based, cross-sectional study of 310 treated hypertensives (HT) and 288 matched normotensive controls (NT), social and biological variables were investigated. HT comprised a higher proportion of individuals in lower socioeconomic strata (P < 0.001) and lower social class distribution (defined by occupation and educational level) than NT. However, lower estimated risks (odds ratios, OR) for hypertension were found in lower social strata than in higher ones for most biological variables. This does not support the hypothesis of an increased general susceptibility in lower social classes to standard risk factors as a main factor behind the higher prevalence of hypertension, in as much as the ORs for most variables were not higher in the lower classes than in the higher ones. Thus, there may exist some, as yet undefined, and more specific risk factors for hypertension which are more prevalent in lower social strata. Interestingly, it was demonstrated that the prevention potential regarding intervention against biological risk factors had about the same magnitude in the different social strata.

Case-Control Studies↗
PubMed1994

[Smoking and social class in France 1974-1991].

We examined trends in cigarette smoking behaviour in France from 1974 to 1991 separately for men and women as well as according to social class indicators. Overall, cigarette smoking prevalence has declined among men but has increased among women over the 18-year period which was taken into consideration. Analysis by social class groupings shows, among men, that the decrease is greater among higher level executives, professionals and academics and occurred as early as 1983. Among women, there is only a slight and recent downward trend limited to those of higher socio-economic status. These findings are similar to those of other southern European countries, such as Italy or Spain, but are not as yet comparable to what has been observed over the last twenty years in northern Europe, the United Kingdom or the United States of America.

Adolescent↗
PubMed2005

Social class in asthma and allergic rhinitis: a national cohort study over three decades.

The aim of this study was to assess whether the association with social class differed between allergic rhinitis and asthma and whether these associations have changed over time. The Swedish Military Service Conscription Register was linked to two other national registers for 1,247,038 male conscripts in successive cohorts born between 1952 and 1977. The percentage of asthma cases associated with allergic rhinitis was 15% in the oldest cohort and 44% in the youngest cohort. Low socio-economic status (SES) was associated with an increased risk (assessed as odds ratio) of asthma without allergic rhinitis (1.14, 95% confidence interval (CI) 1.11-1.17) but a slightly reduced risk of asthma with allergic rhinitis (0.96, 95% CI 0.93-1.00). The risk of allergic rhinitis was 0.84, 95% CI 0.82-0.85. A positive interaction between SES and year of birth occurred in all three conditions. Low SES was related to a reduced risk of asthma with allergic rhinitis in the earliest cohort (0.72, 95% CI 0.53-0.82) but a slightly increased risk in the most recent cohort (1.07, 95% CI 1.01-1.14). In conclusion, the role of social class has changed over time. The steepest increase in asthma and allergic rhinitis occurred in conscripts with a low socio-economic status.

Adolescent↗
PubMed1977

Social class in the mental health center.

To test whether the preference for middle and upper class clients, found in psychotherapeutic clinics during the 1950s and early 1960s, exists in mental health centers, the relationships between social class and various aspects of psychiatric treatment are investigated in forty mental health centers which vary in several organizational dimensions. In general, clients are given treatment with little or no regard to social class. The variables that account for the different patterns of treatment in the two types of psychiatric treatment organizations are (1) the composition of the staffs; (2) the types and amount of individual psychotherapy given; and (3) the primary organizational goal.

Adult↗
PubMed1987

Age, sex, social class, and quality of family interaction as determinants of adolescents' future orientation: a developmental task interpretation.

This study is concerned with the effect of age, sex, social class, and quality of family interaction on the future orientation of adolescents aged 10-11, 14-15, and 17-19 years. Seventy-three girls and 75 boys were interviewed about their future hopes and fears. The content and extension of each aim and fear as well as the amount of planning, knowledge, and perceived locus of control involved was estimated from answers. The contents of aims and fears were closely related to the developmental tasks. Nearly half the subjects were afraid of war. The extension of subjects' future orientation decreased, whereas their knowledge about the future increased with age. The subjects from the higher social classes were oriented farther into the future than those from the lower classes. An interpretation emphasizing the importance of the principal developmental tasks on young people's future orientation is discussed.

Adolescent↗
PubMedDate not supplied

Schizophrenia, social class and immigrant status: the epidemiological evidence.

BACKGROUND: By the mid-1960s, the importance of socio-economic status for schizophrenia had been demonstrated in terms of differences between social-class groups in prevalence and incidence rates, illness course and outcome, and treatment experience. In the causation-selection debate, however, opinion had swung in favour of the selection hypothesis. AIMS: To reassess evidence on the social-class distribution of schizophrenia in Britain, and to compare this body of research with population-based studies of schizophrenia risk in socially disadvantaged ethnic minorities. METHOD: Systematic review of medical and psychological data-bases. RESULTS: Epidemiological research, while confirming the importance of premorbid social decline, has also provided support for the environmental 'breeder' hypothesis. High psychosis rates have been confirmed in ethnic minorities; in particular among Afro-Caribbean and other Black immigrants whose low social status cannot be accounted for by selective downward social drift or segregation. CONCLUSIONS: There are striking parallels, both in the epidemiology of schizophrenia and in social characteristics, between the lower-class indigenous groups highlighted by earlier psychiatric surveys and African-Caribbean populations in Britain's inner cities today. These similarities underline the need for a broader perspective in the search for environmental risk factors.

Emigration and Immigration↗
PubMed1985

Defeminization and social class.

The hypothesis that there might occur selective defeminization by social class between childhood and adulthood among homosexual men was explored. Interview data on 686 homosexual men were employed. It was found that there is a greater tendency for cross-gender propensities to persist into adulthood among respondents from blue-collar backgrounds. Effeminate respondents from such backgrounds were found to be disproportionately involved in same-sex sexual activities during adolescence. They were also sexually responsive to same-sex persons earlier. The interpretation is offered that early homosexual experiences reinforce cross-gender propensities among blue-collar respondents because of the greater gender role dichotomization found in blue-collar culture. Such reinforcement may explain the tendency for there to be greater persistence of cross-gendering among blue-collar men.

Adult↗
PubMed1975

XYY syndrome, stigmatization, social class, and aggression: study of 15 cases.

This is a paper about the relationship of stigmatization to social class in XYY individuals, and of this relationship to manifestations of agressive behavior. The sample comprised 15 men and youths with the XYY syndrome; 8 were identified in a survey of institutions for males with behavior disorders and 7 were privately referred. All had been stigmatized by physique and appearance and/or behavior. The most frequent stigmatizing features were excessive height for age, excessive impulsiveness in behavior, and excessive temper tantrums in childhood; these were present in all cases. Antisocial or law-breaking behavior was present in 13 cases. Stigmatization did not correlate with socioeconomic class, rated according to the Shevky and Bell scale as modified to suit the study. However, the consequences of stigmatization were class related in that the lower the class, the greater the chance that the XYY individual would spend time in the penal as well as the medical system of society.

Adolescent↗
PubMed1991

Social class distribution of obese Chinese children.

Four hundred and eighty four obese Chinese children who were defined obese by a relative weight of more than 120% of standard weight-for-height had their social status evaluated. The social class of each child was arbitrarily determined according to the father's occupation. The distribution of obese children in various social levels was compared with that of the working population in Singapore. Significantly greater proportions of children were in the upper and middle social classes compared with the general working population. Such trends may be related to the increased affluence of the society and the accompanying changes in life-styles and eating habits, and will influence measures in health education and control of childhood obesity in the future.

Child↗
PubMed1990

Social class disparities in risk factors for disease: eight-year prevalence patterns by level of education.

This article examines the associations between education, a primary indicator of social class, and six risk factors for disease. Data are presented on a sample of 3,349 individuals ages 25-74 years who participated in one of four cross-sectional surveys conducted by the Stanford Five-City Project between 1979 and 1986. The six risk factors examined are knowledge about health, cigarette smoking, hypertension, serum cholesterol, body mass index, and height. A highly significant pattern of associations was found between education level and the six risk factors, in the direction of higher risk among those with lower education (all P values less than 0.01). These associations persisted for both sexes and in the younger as well as the older age groups, with the exception of cholesterol values for males and for those in the 50 to 74-year-old age group. Furthermore, all associations remained highly significant after controlling for income and occupation, two other indicators of social class. When a summary-adjusted risk score was plotted against year of survey for the five education levels, a gradient of effect was observed where each progressive education level showed a decrease in total risk score. This gradient was replicated in all four cross-sectional surveys, providing evidence for the consistency of the findings over time.

Adult↗
PubMed1993

The prevalence of dental caries and gingivitis and their relationship to social class amongst nursery-school children in Nairobi, Kenya.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Age Distribution↗
PubMed1992

[Morbidity and social class in Finland, Sweden and Norway].

Investigations of living standards in Norway, Sweden and Finland in 1986-1987 yielded new comparative data on public health and disease as related to social class. Long-term troublesome illness was less common in Sweden than in Finland and Norway. In all three countries the jobless category and skilled working women accounted for the highest morbidity. Among men, morbidity was greatest for agricultural workers in Finland and Norway, and lowest for Swedes of social class 1--i.e., highly placed and highly educated white collar workers.

Adult↗
PubMed1978

Prostatic cancer: mortality and incidence rates by race and social class.

Among the most striking epidemiologic characteristics of prostatic cancer in the United States is the sizeable excess in rates for the disease among blacks as compared with whites. This study attempted to determine whether the higher black rates might be explained by controlling for social class, using mortality data from Alameda County for the pericensal period 1968--1972 (n = 400), and the population-based series of cases for Alameda County included in the Third National Cancer Survey, 1969--1971 (n = 750). Reviewed first are previous studies addressed to the relationship of prostatic cancer and socioeconomic status (SES), most of which have been confined to whites. In the present study, each death or case was assigned to a socioeconomic class based on census tract of residence and rates by race and social class determined. Comparison of age-specific mortality and incidence rates by SES reveals no gradient for prostatic cancer in either whites or blacks.

Black or African American↗
PubMed1988

Social class and psychiatric disorder. The examination of an extreme.

Relationships between social status and various aspects of mental disorder have been of long-standing interest to both clinicians and researchers, and a large body of literature exists attesting to the importance of social status in understanding psychiatric illness and disability. Reports examining social status and schizophrenia suggest that relationships between socioeconomic status and psychiatric illness may rest heavily upon differences between the lowest socioeconomic stratum and the remainder of society. To investigate the extent to which relationships between socioeconomic status and psychiatric illness and disability reflect differences between a deviant lowest socioeconomic stratum and the remainder of society, data from 217 patients hospitalized for psychiatric disorder and reassessed at a 2-year follow-up were examined. At initial assessment, 17 patient characteristics were found to be associated with socioeconomic status; for seven of these 17 characteristics, the largest difference between classes was found between the lowest and the adjacent (next-lowest) social class. At follow-up, for five of 15 characteristics found to be related to social class, the greatest interclass difference occurred between the lowest and the adjacent social class. Both initially and at follow-up, significant associations between patient characteristics and social class remained when the lowest social class patients were excluded from the analyses.

Follow-Up Studies↗