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PubMed1990

Variation in heart disease mortality across census tracts as a function of overdispersion and social class mixture.

Variation in heart disease (HD) mortality rates across census tracts is greater than expected given binomial error and available explanatory variables. We extended an extra-binomial variation model for rates standardized by the direct method. The overdispersion parameter accounted for 36 per cent of the observed variation in standardized rates. Ignoring overdispersion resulted in a change in an estimate of the effect of social class on HD mortality and substantial underestimation of the error of the estimates of such effects. Ecologic regression on the proportional mixture of social classes within tracts provided an appealing approach to the problem of estimating fixed effects with aggregated data.

Adolescent↗
PubMed1996

Social class and behavior: simultaneous class positions yield different amounts of income.

We used data from the Panel Study of Income Dynamics to present preliminary findings on the social class behavior of the poor and general populations in the USA. Analysis supported the potion that individuals are engaged simultaneously in multiple class positions, e.g. self-employed and welfare recipient, that yield different amounts of income. Moreover, no single label or explanation, e.g., "underclass" of "the poor are marginal to the economy," seems appropriate to describe the complexity or the economic behavior of poor individuals.

Hierarchy, Social↗
PubMedDate not supplied

Suppressed anger and blood pressure: the effects of race, sex, social class, obesity, and age.

We studied 572 men and women who participated in a blood pressure screening program at a government unemployment office. Before having their blood pressures taken, the subjects completed a brief questionnaire that included two items measuring conflict over anger expression. Information was also obtained on obesity, race, sex, social class, and age. Across all subjects, systolic blood pressure was found to be significantly related to suppressed anger (p less than 0.016). Normotensive were twice as likely as hypertensives to be free of suppressed anger. This relationship remained after controlling for the covariates of age, social class, and obesity. The relationship between suppressed anger and systolic blood pressure was significant for white men, exhibited a trend in black men, and was not significant for women. In contrast to the systolic findings, suppressed anger was unrelated to diastolic pressure in all the analyses.

Adult↗
PubMedDate not supplied

Social class, prenatal care, maternal age and parity: a study of their interrelation in six Italian centres.

"Multiple Correspondence Analysis was used to describe the complex structure formed by those sociodemographic variables, whose association with the occurrence of prenatal and neonatal deaths and diseases has been most frequently stressed in literature: social class, prenatal care, maternal age and parity. The study regards 41,537 women included in a multicentre survey of perinatal preventive medicine, which was carried out, between 1973 and 1979, in six Italian centres...." It is found that "in all centres there are distinct groups of women characterized by a set of unfavourable factors closely interrelated: low social class implies lower prenatal care, higher occurrence of precocious or belated childbearing and higher number of pregnancies, often unintended." (SUMMARY IN FRE AND ITA)

Age Factors↗
PubMed1995

The influence of social class on parity and psychological reactions in women coming for induced abortion.

OBJECTIVE: To test the hypothesis that the correlation between legal abortion and socio-economic conditions, known from the time when abortion was restricted, has current validity. To evaluate the effect of social class on network support and psychological reactions. DESIGN: Consecutive sampling and semistructured personal interviewing. SUBJECTS: 444 women living in the city of Gothenburg and applying for legal termination of pregnancy in the first trimester. SETTING: The department of gynaecology at a university hospital with primary care responsibility for legal abortions. RESULTS: The 667 health administration districts of Gothenburg were ranked into four groups according to the mean income. Women living in lower socio-economic districts were younger. Irrespective of age, previous experience of induced abortion was more common among them (p < 0.001). Unsatisfactory network response or support was common (37%), but equally shared between the social classes. Discontinuation of oral contraception during the previous six months was twice as common among teenagers (40.0%) as among other women (p < 0.001) but without social differences. Pitman's permutation test was used for statistical analyses. CONCLUSION: Socio-economic conditions have a strong and inverse correlation to previous experience of induced abortion. Psychological reactions and needs did not vary with class.

Abortion Applicants↗
PubMed1990

Social class and human twinning.

In a comparative study to examine the effect of social factors on human twinning, data on sociodemographic and other factors were collected from parents of all twins born alive in Denmark in 1984 or 1985 and from a random sample of parents of singleton infants born in the same years. A postal questionnaire was used. The twins were classified as monozygotic (MZ) or dizygotic (DZ) twins by the similarity method. A trend was found in DZ-twinning, with significantly fewer DZ-twins born in the lower social classes, but not in MZ-twinning. All results were controlled for maternal age and parity.

Adult↗
PubMed1998

["Sense of coherence", social class and health in a Danish population study].

The objectives are a) to present Antonovsky's concept Sense of Coherence (SOC) and his 13-item SOC-scale, b) to describe the distribution of SOC in a random sample of five age groups in the Danish population, and c) to study the association of SOC to sex, age, social class, and health. The Danish Longitudinal Health Behaviour Study (DLHBS) collected self-administered questionnaire data from a random sample of the population born in 1975, 1965, 1940, 1930, and 1920. The baseline study took place in 1990, response rate 71%, n = 2,858. The article reports data from the first follow-up in 1994, response rate 86% of the survivors, n = 2,352. SOC shows no gender differences; it is significantly lower in the youngest age group and increases with age. SOC is highest in the highest social classes. Poor SOC is associated with poor self-rated health and high prevalence of symptoms. Poor SOC is associated with high prevalence of long-term illness among respondents older than 50 years of age.

Adaptation, Psychological↗
PubMed1973

Respiratory disease in young adults: influence of early childhood lower respiratory tract illness, social class, air pollution, and smoking.

The prevalence of cough during the day or night in winter has been studied in 3,899 20-year-olds. These were members of a cohort born in England, Scotland, and Wales in the last week of March 1946. The prevalence of cough and current smoking habits have been related to events recorded during infancy and childhood-that is, exposure to air pollution, social class of father, and lower respiratory tract illness under 2 years of age. At age 20, of these factors cigarette smoking was found to have the greatest effect on symptom prevalence, followed by a history of a lower respiratory tract illness under 2 years of age. Social class and air pollution had little effect.

Adolescent↗
PubMed1995

The role of race/ethnicity and social class in minority health status.

Minority health is often considered as a unitary phenomenon; it is often assumed that the health status of minority groups in the United States is similar across groups and much worse than that for whites. Yet the reality is extraordinary diversity. Racial/ethnic groups differ greatly both among and within themselves with regard to health status and with regard to a large number of other indices. Mortality rates around the world generally show an inverse relationship with social class. While this generally holds true in the United States as well, once again we see a strong interaction with race/ethnicity. However, the mediating factors between race/ethnicity and social class, and health status are not well understood. Especially in the face of health care reform, a broad-based research agenda needs to be undertaken so that any restructuring of the health care delivery system is informed by empirical information.

Adolescent↗
PubMed1985

Identifying children at high somatic risk (alpha 1 antitrypsin deficiency): possible long-term effects on parents' reproduction, marital status and social class level.

Neonatal identification of children at high somatic risk due to inherited alpha 1 antitrypsin deficiency (ATD) has been found to elicit a negative emotional reaction in a majority of the parents, at least initially. This sub-study was conducted to determine whether the identification and follow-up of the children's ATD had negatively influenced the families' reproduction, marital status and social class level (defined by parental occupation) during the 5 years following the identification of the children's ATD. No such negative effects were found in comparing these characteristics among 61 families with a child with ATD versus 183 control families living in the same area and having a child of the same sex and age. Unexpectedly, the ATD-children's families (fathers) had a significantly higher social class level, raising the question of a possible gene advantage associated with ATD.

Child↗
PubMed2004

Smoking, social class, and gender: what can public health learn from the tobacco industry about disparities in smoking?

OBJECTIVE: To discover how the tobacco industry considers social class and gender in its efforts to market cigarettes in the USA, particularly to socially disadvantaged young women. METHODS: A systematic on-line search of tobacco industry documents using selected keywords was conducted, and epidemiological data on smoking rates reviewed. RESULTS: The two largest cigarette manufacturers in the USA consider "working class" young adults to be a critical market segment to promote growth of key brands. Through their own market research, these companies discovered that socially disadvantaged young women do not necessarily desire a "feminine" cigarette brand. CONCLUSIONS: Considering the tobacco industry's efforts, alongside the persistent and growing disparities in cigarette smoking by social class, and the narrowing of differences in smoking by gender, it is concluded that additional tobacco control resources ought to be directed toward working class women.

Adolescent↗
PubMed2006

Schizophrenic subtype, seasonality of birth and social class: a preliminary analysis.

OBJECTIVE: The neurodevelopmental model of schizophrenia includes the etiological impact of fetal brain stressors possibly connected with birth seasonality. Specification of social class of origin (SES) as a related risk factor remains unexamined as does type of schizophrenia as an outcome variable. The objective of this study was to test for an interconnection between SES, type of schizophrenia and seasonality of birth. METHODS: Patients (N=436) from a United States psychiatric hospital were separated into deficit/non-deficit presentation and bifurcated into poor/non-poor SES. Birth seasonality was assessed by months hypothetically connected with winter-related trimesters of gestation. RESULTS: Results showed that there is a significant difference (p=0.0411) in the monthly birth patterns of poor vs. non-poor patients and that the difference connects with the likelihood of deficit vs. non-deficit schizophrenia. Specifically, an elevated proportion of patients with deficit schizophrenia were born to impoverished women who likely conceived in January. Findings were confirmed by multiple levels of statistical assessment including log linear analysis. CONCLUSION: The resultant model suggests the environmental location (lower SES) and timing (winter conception) of adult schizophrenia with poor outcome (deficit).

Female↗
PubMed1982

Contributions of different lipoprotein fractions to variations in total cholesterol between Israeli origin groups and social classes.

Total cholesterol, triglycerides and high-density lipoprotein (HDL)-cholesterol were measured in 2,306 boys, 1,716 girls, 2,479 fathers and 2,822 mothers examined on Visit 1 of the Jerusalem Lipid Research Clinics Prevalence Study in 1976-79. Low-density lipoprotein (LDL)-cholesterol levels were estimated from the other three measurements. Using multiple regression analysis to control for body mass index, social class, season of the year and (in parents) age, we compared the three origin groups (Asian, North African and European, depending on the birthplace of the parents) with the Israeli-born group. In both fathers and mothers, the lower total cholesterol levels in the North African group, and to a lesser extent in the Asian, were explained mainly by lower LDL-cholesterol in these groups. In youngsters, the origin groups were characterized by differences not only in LDL-cholesterol, but also in other lipoprotein fractions. Social class in youngsters and mothers was associated mainly with the HDL-cholesterol fraction; in fathers it was associated only with triglycerides. Possible relationships of these findings to smoking, alcohol, exercise and female sex hormones are discussed.

Adolescent↗
PubMed1993

[Patterns of drug abuse among youngsters of upper social class].

Street drug use, and alcohol abuse among young adults from a high social class range were studied in the posh seaside resort of Punta del Este (Uruguay) during the (austral) summer vacation (February 1993). In this connection, an anthropological methodology was applied: Four young people were trained in systematic record and observation technics abilities. Results suggest two clearly defined social-cultural patterns with regard to both cannabis, and cocaine use. Both patterns take place within a social environment agreeable to drug use as well as strongly connected with social interaction ways peculiar to high-class youth.

Adolescent↗
PubMed1991

A study of developmental defects in enamel in 10-year-old high social class children residing in a non-fluoridated area.

This study investigated the relationship between reported exposure to fluoride in the form of toothpaste and fluoride supplements, the level of observed developmental defects in enamel and the caries experience in a sample of 10-year-old children. Using a modified and simplified version of the developmental defects of enamel index, 300 10-year-old children who had been continually resident in non-fluoridated high social class areas were examined. The examination was followed by a questionnaire to parents on their child's fluoride supplement and toothpaste usage, and toothbrushing habits in early childhood. The prevalence of developmental defects in enamel was lower than that reported elsewhere. A large number of children had diffuse developmental defects but had no history of exposure to fluoride supplements. The only differentiating factor between this group and a similar group with no diffuse defects was in the amount of toothpaste dispensed during toothbrushing prior to the age of six. There was no association between caries experience and the presence or absence of developmental defects. It was concluded that parents of children from a high social class background should supervise the brushing of their children's teeth and use only a pea-sized amount of toothpaste.

Age Factors↗
PubMed1976

Inpatient and emergency department utilization: the effect of distance, social class, age, sex, and marital status.

This study attempted to measure whether patients using two hospital services -- inpatient facilities and the emergency department -- were representative of the population. It sought to confirm the assumptions that, if patient demands were uniform and there were no barriers to emergency department use: (1) emergency patients would closely represent the population in the geographic service area of the hospital, and (2) factors such as distance from residence, age, marital status, social class, and sex, would be relatively uniform between inpatients and emergency patients. The first assumption was supported by the results of the study. Concerning the second, the 0- to 19-year-old group had a high emergency department utilization and low utilization of inpatient facilities when 35- to 65-year-old group had a lower emergency department and a higher inpatient usage pattern. The 65-year-old and over group had two and one-half times as many inpatient admissions as their number in the general service area would suggest. More men than women used the emergency department. Separated and divorced people were heavy users of the emergency department whereas widows heavily used inpatient facilities. Social class was not found to be significantly different among those using the inpatient service or emergency department.

Adolescent↗
PubMed1990

Social class differences in years of potential life lost: size, trends, and principal causes.

British social class differences in mortality are examined in terms of years of potential life lost, a measure that gives more weight to deaths that take place at younger ages. It shows wider class differences during the years of working life than those found when mortality is expressed in terms of standardised mortality ratios. Examination of the change in class differences between 1971 and 1981 for all causes of death combined and for the three categories of death which during these ages make a major contribution to total years of potential life lost shows complex changes. Inequalities in years of potential life lost have increased between 1971 and 1981, during which all the principal causes of death have shown stationary or rising rates among the manual classes. The use of years of potential life lost as a measure of population health trends focuses attention on the major contribution of violent death, which occurs mainly in younger men, to widening class differences in mortality.

Adolescent↗
PubMed2000

Social class, sex, and age differences in mucosal immunity in a large community sample.

There have been very few reports addressing levels and distribution of commonly used PNI measures in large community samples. In this study, we report such data for secretion rates of secretory immunoglobulin A (sIgA), as determined from saliva samples taken from 1971 subjects interviewed as part of the West of Scotland Twenty-07 survey of health in West Central Scotland. Univariate analyses of demographic variables found lower sIgA and salivary flow to be significantly related to poorer social class, increased age, and being female. Smokers also had lower sIgA but not lower salivary flow. Multivariate analysis showed that demographic variables were significant predictors of sIgA independently of each other and assay variation. Adding smoking status to the equation confirmed it as an independent predictor and also indicated that social class differences in sIgA are partly explicable in terms of smoking status. In view of reported associations between sIgA levels and stress, its role as a first line of mucosal defense, and its relevance to health, these first results from a large survey are of interest. Further work is now needed to explore which factors, including psychosocial ones, may be contributing to subgroup differences.

Adolescent↗