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PubMedDate not supplied

Association between social class and food consumption in the Italian EPIC population.

AIMS AND BACKGROUND: The objectives of the present study were to validate the social stratification variables adopted by the European Prospective Investigation into Cancer and Nutrition (EPIC) by comparing them with data from another independent source and to evaluate the geographic and social distribution of eating habits in the Italian EPIC population. METHODS: The validation of the socioeconomic data collected by the EPIC study was performed with the Turin Longitudinal Study as gold standard and using Cohen's kappa statistics to evaluate the concordance between the studies. We then analyzed food groups based on the consumption of meat and fats, carbohydrates, sweets and alcohol, and on an index of the Mediterranean diet. The standardized scores for each food group were subdivided into quartiles, which were used to compare persons in the extreme quartiles. Analysis of the differences in eating habits by center and by educational level was conducted separately for men and women, calculating the prevalence rate ratios and controlling for age, area of birth and body mass index. RESULTS: Concordance between the two data sources was high for educational level and low for the social-class index based on occupation. Most of the eating habits considered to be potentially harmful (high consumption of meat or fats and alcohol and low consumption of olive oil and fish) were more frequent in Northern than in Southern Italy. These habits were inversely correlated with educational level, especially in the South. CONCLUSIONS: A significant improvement in health could be obtained in the Italian population if culturally and socioeconomically disadvantaged individuals were to abandon their diet rich in meat and fats, as done by more advantaged persons. In the absence of preventive interventions specifically addressed to disadvantaged groups, it is likely that social inequalities in mortality and morbidity will increase.

Adult↗
PubMed1999

[Social class index in the Federal Health Survey].

Since the first scaling of social status for the German National Health Interview and Examination Survey, relevant socio-economical circumstances and constraints have changed. This prompted an examination of relevant developments such as changes in income distribution and increasing income in the West and since 1990 in the East of Germany, changes in educational levels, and changes in social prestige of professional groups. In spite of these changes we must assume that the relations between social strata remained constant over time. The task is to assess how and to what extend the developments mentioned above have been reflected and to examine the necessity of bringing social status scaling in line with these developments, as well as to adjust social status scaling.

Adolescent↗
PubMed1987

Cancer survival and social class in Sweden.

A study of 98,000 cases in the Swedish Cancer Registry from 1961 to 1979 was undertaken. The relative survival by social class was calculated. There was a higher survival probability for white collar workers than for blue collar workers or self-employed farmers for all cancer, as well as for particular cancers, such as, for instance, cancer of the breast and cervix among women and cancer of the rectum among men. For lung cancer, cancer of the stomach, and pancreatic cancer there were no detectable differences in survival probability. The findings can be considered in the light of various possible explanations, for instance, early detection, differential treatment, and host factors.

Female↗
PubMed1987

Cancers of affluence: positive social class gradient and rising incidence trend in some cancer forms.

This study shows that, unlike most diseases, some cancer forms are more common in upper social classes. All cancer cases diagnosed in Finland in 1971-75 aged 30-69 and recorded in the Finnish Cancer Registry (n = 36,500) were linked to the file of the 1970 Population Census of Finland with data on socio-economic status and education. Cancers related to both high socio-economic status and high level of education in men were colon, prostate, testis, kidney and melanoma of the skin, and in women colon, breast, and corpus uteri. Since 1953, the incidence of all these cancers had been rising, although that of the testicular cancer had levelled off in the seventies.

Adult↗
PubMed2004

Attenuation of social class and reproductive risk factor associations for Hodgkin lymphoma due to selection bias in controls.

OBJECTIVE: Hodgkin lymphoma (HL) risk has been linked with higher social class and lower parity, but our prior population-based case-control study in adult women had unexpected null findings for these variables. Because subject participation was 87% for cases but 65% for random digit-dialing (RDD) controls, we examined representativeness of our controls and the impact of detected bias on prior results. METHODS: Using data from RDD enumeration, abbreviated interviews with nonparticipating controls, and the US census, we compared participating and nonparticipating RDD controls across several age groups and then recomputed odds ratios for risk factor associations adjusted for bias. RESULTS: The 325 RDD control participants were younger, more likely to be white, better educated, and of lower birth order and lower parity than the nonparticipants. Adjustment of odds ratios for bias strengthened previously null findings for education and for parity, breast-feeding and miscarriages in young adult women; these latter changes eliminated previously apparent age modification of risks. CONCLUSIONS: Selection bias in female RDD controls resulted from differential participation by socioeconomic factors, varied with age, and produced underestimations of several associations in young women, including reproductive factors. Thus, our prior conclusions of etiologic irrelevance for some study variables may have been inaccurate.

Abortion, Spontaneous↗
PubMed1993

Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization.

OBJECTIVE: To establish basic epidemiological data on chronic pain (duration > 3 months) in a defined population. Relationships between age, gender, and social class were tested. DESIGN: A survey of pain symptoms, including location, intensity, duration, and functional capacity, was conducted by means of a mail questionnaire. SETTING: General populations in two Swedish primary health care districts. Medical care was provided in a state health system. SUBJECTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1,806). The response rate was 90%. OUTCOME MEASURES: Descriptive epidemiologic data in relation to objectives of the study. RESULTS: Without sex differences, 55% (95% confidence interval, 53-58%) of the population had perceived persistent pain for 3 months and 49% for 6 months. Among individuals with chronic pain, 90% localized their pain to the musculoskeletal system to a variable extent. Women experienced more multiple localizations of pain and had pain in the neck, shoulder, arm, and thigh to a greater extent than men. Prevalence of pain increased by age up to 50-59 years for both genders and then slowly decreased. The neck-shoulder area was the most common site of pain (30.2%), followed by the lower back (23.2%). Even in the youngest age groups more than one of four reported chronic pain. Blue-collar workers and employers (including farmers) reported chronic pain to a greater extent than other groups. In 13% of the population, manifest pain problems were associated with reduced functional capacity. CONCLUSION: Chronic pain symptoms are common but unevenly distributed in a general population. The results may influence planning and consultation in primary health care as well as warranting selective prevention activities.

Adult↗
PubMed1985

[Average body height of the middle and lower social classes in the middle European Germanic settlement area from the early Middle Ages to modern times].

This paper reviews the body height data of middle and low social classes of North and Central European populations from the early Middle Ages until the beginning of the 17th century. It is mainly based on anthropological data from the ancient Germans, but considers also some historical reports. From the data presented here it is seen that the initially rather considerable body heights in these two social groups are decreasing during the Middle Ages. This could be observed on population samples from the Central German Highlands and from Southern Germany as well as on samples from the utmost Western Teutonic settlement: Greenland. The reasons for these variations are most likely to be seen in nutritional changes, in increasing hard physical work due to the transition to predominating agriculture, in biological effects of birthrights, and in deteriorating hygienic conditions.

Anthropology, Physical↗
PubMed1999

Fibrinogen and factor VII levels are related to adiposity but not to fetal growth or social class in children aged 10-11 years.

Factors operating in fetal life or during childhood may be important in determining fibrinogen and factor VII concentrations in adult life, and particularly in explaining social gradients in cardiovascular disease risk. In 1994, the authors measured fibrinogen and factor VIIc levels in 641 children aged 10-11 years (61% response rate) from schools in five towns in England and Wales. Birth weight was obtained by maternal recall, and other data on measures of fetal growth were obtained from birth records. Fibrinogen levels were higher in girls (258.8 mg/dl) than in boys (245.4 mg/dl) (95% confidence interval (CI) for difference: 5.5, 21.5). Fibrinogen and factor VIIc levels were linearly related to adiposity, rising by 37.1 mg/dl (95% CI: 24.7, 49.5) and 13.0% of standard (95% CI: 6.3, 19.7), respectively, between the bottom and top quintiles of ponderal index (weight (kg)/height (m)3). Fibrinogen was independently related to heart rate (p < 0.001) and was negatively but nonsignificantly related to measures of physical activity. Factor VIIc was positively correlated with total cholesterol (p < 0.001). No relations were found with measures of fetal growth or social class. These data do not support the concept that fibrinogen or factor VII levels are determined in utero or by social factors in childhood. Adiposity and physical training appear to be the important determinants of fibrinogen and factor VII levels in childhood.

Adipose Tissue↗
PubMed1989

Mortality and social class in Sweden--exploring a new epidemiological tool.

Total mortality, mortality from coronary heart disease (CHD), cerebrovascular disease, and other causes of death, were examined for three social groups and ten socio-economic groups in Sweden. The study included all subjects born in the country between 1896 and 1940 who were economically active in 1960-1.9 million men and 0.7 million women. Information on social and socio-economic status, and other social and demographic characteristics, was obtained from the 1960 Census. Information on cause-specific mortality during the period 1961-68 was obtained from a record linkage with the Cause of Death Registry. The analyses were based on 112,469 deaths and 21 million person years at risk. Information on smoking habits was obtained from a sample of 55,000 from the Census population. CHD mortality for women was high among manual workers, SMR = 110 (95% confidence limits 104-117), and low among non-manual workers, SMR = 84 (78-91). CNS-vascular mortality for women was also high among manual workers, SMR = 107 (110-115), and low among non-manual workers, SMR = 89 (82-97). Heavy smoking was more common among non-manual workers in both sexes, which may have contributed to a reverse social class gradient among men, with non-manual male workers being at higher risk for CHD than manual male workers. Farmers (and agricultural workers) generally had a low mortality. Other self-employed men and women had a high total mortality, a high mortality from CHD and CNS-vascular disease--and a high proportion of heavy smokers. There remain differences in mortality between social and socio-economic groups which cannot be explained by smoking habits, age, gender, urbanization, region of residence and martial status.

Adult↗
PubMed1976

Social class and morbidity in clinically treated alcoholics.

The lifetime physical disease profiles of 122 lower and 724 middle class non-skid row alcoholics admitted to an inpatient treatment facility were compared to further clarify the significance of social class as a determinant of morbidity in alcoholics. The overall severity of physical disease and the frequency of all recorded lifetime illness diagnoses were greater in the lower than in the middle class. The former experienced more trauma, genitourinary disorders, venereal disease and malnutrition, as well as small excesses of respiratory and nervous system disorders. There were no class differences in the lifetime frequencies of liver and biliary tract, gastrointestinal, cardiovascular, endocrine and metabolic, integumentary, locomotor and haemopoietic disorders, or in the incidences of a number of disease entities including acute brain syndromes and chronic brain damage. The drinking patterns of the classes were similar, but the average duration of hazardous drinking was longer and the average current consumption was greater in the lower class. There were no class differences, however, in the average duration of hazardous drinking before the first occurrence of certain diseases. The referral sources of the classes were significantly different. Possible explanations for the differences between the findings of this and earlier studies are discussed.

Adult↗
PubMed1980

The effects of race and social class on clinical judgment.

Asked 61 male clinical psychologists (21 blacks and 40 whites) to assess case histories that were presented to them to determine whether racial or social class biases could be detected. In order to avoid the apparent artificial results or weak interpretations of past research, only cases with concurrently validated diagnoses and 4-year follow-up were used. An equal number of positive and negative clinical outcomes were included. Diagnosis, disposition, and rated severity were studied. The following results were found: (1) diagnosis for all psychologists was guided by case characteristics, not bias; (2) severity was related strongly to diagnosis; (3) disposition followed judgments of severity and diagnosis, not bias. The question was raised whether clinical investigators may not have overdramatized bias in psychodiagnosis and clinical judgment.

Alcoholism↗
PubMed1988

Incidence of IDDM in Montreal by ethnic group and by social class and comparisons with ethnic groups living elsewhere.

We examined the incidence of insulin-dependent diabetes mellitus (IDDM) among children aged 0-14 yr in Montreal by social class and by ethnic group from 1971 to 1985. There was a slightly higher risk in wealthier as opposed to poorer classes. This income gradient was more marked in younger than in older children. Children of French extraction had about two-thirds the risk of IDDM of children of other origins, mainly British and other European. This mimics the patterns of risk in Europe, where France is reported to have lower rates than does Britain and Scandinavia. The absolute levels of risks among French Canadian and Jewish Canadian children were about double those reported from France and Israel, respectively. These various results are compatible with the hypothesis that both genetic and environmental factors influence IDDM risk.

Adolescent↗
PubMed1992

Social class and diachronic trends in physique in young university women.

In a large sample of female students admitted to the University of Warwick in the period 1971-86, physique as measured by height, weight and ponderal index was examined in relation to family variables and socioeconomic class. Stature and weight both show a secular tendency to increase, and there is no indication of any slowing of rate. The different social classes do not participate equally in these trends, in a way that is difficult to reconcile with the attribution of the diachronic changes to simple improvement in environmental conditions. Maternal competence is suggested as a possible factor in the pattern of class difference.

Adolescent↗
PubMed1983

Social class and psychotherapy.

By means of a psychiatric case register the total psychiatric population in the Nacka region (75,000 inhabitants) was analysed during a 2-year period with regard to the amount of psychotherapy consumed in different social groups. Among the patients, the utilization of psychotherapy was 60% for social group I compared with 30% for social group III. However, the lowest social groups are overrepresented at the mental health unit. Thus, among the total population, the utilization of psychotherapy was 1.8% for social group I compared with 5.3% for social group III. The study discusses the "clinical fallacy", by which data from a patient population is applied to the whole population, giving wrong or restricted perspectives to the problem studied. It is claimed that the selectivity of the psychiatric organization concerning social groups is an important factor for the so-called "social class bias" in psychotherapy.

Community Mental Health Centers↗