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PubMed1990

Leukaemia incidence, social class and estuaries: an ecological analysis.

Leukaemia incidence data for 1984-1986 for 22 counties of England and Wales have been collected by a specialist registry. The present study is an ecological analysis in which incidence in electoral wards has been tested for association with two predefined ward characteristics: socio-economic status and proximity to estuaries. Small but statistically significant associations have been observed with relative risks in the range 1.05-1.50. Adjustments have been made in the analysis for variation in the underlying regional incidence and also for statistical artefacts consequent upon the rarity of the condition. The results for socio-economic status confirm those of other recent studies, with increased incidence linked to higher status. The results for estuaries are new although derived from a prior hypothesis.

Adolescent↗
PubMedDate not supplied

The National Study of Health and Growth: nutritional surveillance of primary school children from 1972 to 1981 with special reference to unemployment and social class.

The height, weight for height and triceps skinfold of primary school children in England and Scotland in 1972 and 1981 were compared. Children of both sexes aged 5 to 11 years were taller in 1981 than in 1972. The median triceps skinfold and the percentage of children above the 90th centile of the 1972 distribution also increased, more consistently in boys than in girls. Children with fathers who were unemployed at the time of the survey were taller in 1981 than were the corresponding group in 1972. The difference in height between children whose fathers were unemployed and those who were employed was less in 1981 than it was in 1972, significantly in girls and almost significantly in boys. These findings illustrate that this surveillance system in the UK can document changes in the pattern of growth of children over a short period of time.

Body Height↗
PubMedDate not supplied

Mating structure, isonymy and social class in late nineteenth century Tasmania.

This study analysed all marriages (N = 4258) registered in the island State of Tasmania during the period 1896-1899 for mating structure, using marital isonymy. We found that irrespective of the geographic size of the subdivisions the random component (Fr) values were similar. This is because there was a high proportion of unique names despite the large population size. Fn values were sensitive to geographic distance only with respect to the 'unrealistically' larger units of analysis. Isonymy is valid over very large distances in Tasmania. Inbreeding values in the study were typical of other mainstream populations, but the nonrandom component was unusually high. Farmer marriages were the major contributors to the high Fn values. One particular region, the Midlands, displayed both a high F (0.0081) and Fn (0.0074) component. The explanation of these values lies in the effects of a rigid socio-economic structure established during colonization.

Female↗
PubMedDate not supplied

Race/ethnicity, social class, and prevalence of breast cancer prognostic biomarkers: a study of white, black, and Asian women in the San Francisco bay area.

We assessed distributions of breast cancer prognostic biomarkers by race/ethnicity and socioeconomic position among paraffin-embedded tumor biopsy specimens from 135 US women (48 white women, 44 black women, 43 Asian women) diagnosed with breast cancer between 1966 and 1990. No racial/ethnic or socioeconomic differences in distributions were observed for tumor stage, lymph node involvement, estrogen, progesterone, and epidermal growth factor receptors, oncogenes such as Her2/neu and p53, cytoplasmic proteins cathepsin-D and ps2, and two indices of cell growth, Ki67 and DNA ploidy, adjusting for age at diagnosis, menopausal status, place of birth and, for racial/ethnic comparisons, working class composition of census block-group at diagnosis. Black and Asian women, however, were 3.5 times (95% confidence interval [CI] = 1.2, 10.1) and 3.7 times (95% CI = 1.3, 10.6), respectively more likely than white women to have a tumor size of > or = 20 mm, and Asian women were 3.4 times (95% CI = 1.1, 10.4) more likely than black women to be positive for androgen receptor, adjusting for these same factors. No differences in distributions by socioeconomic position were observed for these latter two tumor characteristics. These data suggest that racial/ethnic and socioeconomic disparities in breast cancer survival are unlikely to be explained solely by differential distributions of molecular breast cancer prognostic biomarkers.

Asian↗
PubMed1989

Growth of South African Indian schoolchildren in different social classes.

The height and weight of 4594 Indian schoolchildren aged 6 to 17 years, in Durban, South Africa, were measured at schools selected by inspectors as representative of upper, intermediate, and lower socio-economic populations. Significant superiority, anthropometrically, prevailed at all ages in upper compared with lower or poor-class children, but tended to lessen at 17 years. In the affluent group, in the age period studied the proportions under the 5th percentile of USA NCHS reference values were--concerning height-for-age 4.7% to 22.0% of boys and 5.0% to 20.7% of girls; and concerning weight-for-age, 20.3% to 45.0% of boys and 9.3% to 37.7% of girls. In the affluent group, at full growth at 17 years, means of height and weight were highly significantly lower, namely, roughly by 7cm and 10kg, compared with respective mean values given in USA reference values. Hence, in Indian schoolchildren a genetic factor, and not dietary inadequacy, appears primarily responsible for both slower post-pubertal growth and lower ultimate height attainment.

Adolescent↗
PubMed2005

Attitudes toward victims of rape: effects of gender, race, religion, and social class.

Although previous literature focusing on perceptions of victims of rape has examined how gender, race, and culture influence the attitudes one holds toward victims, these studies have yielded mixed results. This study compared perceptions of victims of rape across a wide range of ages, educational backgrounds, religions, and income levels, while focusing on gender and racial differences. Results indicate (N = 220) that victims of rape are generally viewed more sympathetically by females than by males and by Whites than by African Americans. However, the effect of race disappears when socioeconomic variables are controlled, suggesting a more complex relationship. Also, a hierarchical regression indicates that age, sex, education, and income are significant predictors of attitudes toward victims. This study builds on existing research that examines such attitudes from a cultural perspective and extends this literature by examining the interactive effects of several demographic variables within a community sample.

Adult↗
PubMedDate not supplied

Low-level lead exposure, social class, and infant development.

A prospective cohort study was conducted to assess the association between early development and low-level prenatal and postnatal lead exposure. Infants' performance between 6 and 24 months on the Mental Development Index of the Bayley Scales of Infant Development declined with increasing concentration of lead in blood, but the decline varied with children's age at exposure, level of exposure, and socioeconomic status. Within the second year of life, the performance of children in lower socioeconomic strata was adversely affected at lower levels of prenatal exposure (blood lead levels of 6 to 7 micrograms/dl) than was the performance of children in higher socioeconomic strata. However, even the performance of these advantaged infants was lower when cord blood lead level exceeded 10 micrograms/dl, well below the figure currently regarded as the maximum permissable level for young children. Exploratory analyses suggested that early postnatal blood lead levels between 10 and 25 micrograms/dl were also associated with lower Mental Development Index scores, but only among children in lower socioeconomic strata.

Aging↗
PubMed1977

Social class, political power, and the state: their implications in medicine--part III.

This is the third part of an article on the distribution of power and the nature of the state in Western industrialized societies and their implications in medicine. Parts I and II were published in the preceding issue of this Journal. Part I presented a critique of contemporary theories of the Western system of power; discussed the countervailing pluralist and power of elite theories, as well as those of bureaucratic and professional control; and concluded with an examination of the Marxist theories of economic determinism, structural determinism, and corporate statism. Part II presented a Marxist theory of the role, nature, and characteristics of state intervention. Part III focuses on the mode of that intervention and the reasons for its growth, with an added analysis of the attributes of state intervention in the health sector, and of the dialectical relationship between its growth and the current fiscal crisis of the state. In all three parts, the focus is on Western European countries and on North America, with many examples and categories from the area of medicine.

Delivery of Health Care↗
PubMed2004

Infant mortality and air pollution: modifying effect by social class.

UNLABELLED: Studies link air pollution with increased mortality; however, information on infants is scarce and inconclusive. OBJECTIVE: We studied short-term PM10 exposure, relating to increased respiratory-related infant mortality, and estimated for poor living conditions. METHODS: A case-crossover approach modeled the relationship between infant mortality (1 month-1 year of age), and ambient PM10 levels on days before death in Ciudad Juarez, Mexico (1997-2001). Socioeconomic level (SES) of the deceased was defined by residence location. RESULTS: Overall air pollutants did not affect infant mortality (odds ratio [OR] = 1.02, 95% confidence interval [CI] = 0.94-1.11 for PM10, lag1) but low SES increased risk. Each 20 microg/m3 in PM10 (24-hour average, lag1, cumulative over 2 previous days) increased respiratory-related mortality (OR = 1.61, 95% CI = 0.97-2.66; OR = 2.56; 95% CI = 1.06-6.17, respectively). Ozone levels did not affect infant mortality for any SES. CONCLUSIONS: Worse living conditions among lower SES concurred with increased mortality.

Air Pollutants↗
PubMed1989

Randomisation by cluster and the problem of social class bias.

For randomised population trials the unit of randomisation is normally the individual person. In some situations, however, investigators take other groups as basic unit and one such design is cluster randomisation. Considerable attention has been given to this design recently in statistical and epidemiological literature. The Edinburgh randomised trial of breast cancer screening is an example which takes general practices as clusters of patients. The experience of this trial is reported here. Mortality from all causes, cardiovascular disease and lung cancer over the first 5 year period of follow up are examined. We found that spurious mortality differences were present in the analyses, which do not allow for socio-economic status. From examination of methods of adjusting for this, we conclude that allowance can be made at the analysis stage, and it is intended that this approach will be adopted when breast cancer mortality is analysed in the Edinburgh trial. Nevertheless, we recommend that for future studies with outcome related to socio-economic status, randomisations which use this design be stratified by socio-economic criteria where this is feasible.

Bias↗
PubMed2005

Social class of origin, lost potential, and hopelessness in schizophrenia.

Among schizophrenia patients, young (under 35 years of age), men within the first 5 years of illness onset are a particularly vulnerable group for suicide. It has been hypothesized that suicide in this group is related to the experience of the loss of functioning from pre- to post-morbid state and/or to the discrepancy between high expectations and actual achievements. The purpose of this study is to initiate the deconstruction of the sociocultural context of family of origin among schizophrenia patients as a means of better understanding "lost potential" and its relationship to indices of suicide risk such as hopelessness. Eighteen young, White, unemployed male schizophrenia patients were asked to indicate what job they thought they would have before the onset of schizophrenia and completed depression and hopelessness questionnaires. The results suggest that job expectation was significantly positively correlated with socioeconomic status of family of origin and patients' depression and hopelessness. The theoretical and treatment (especially with respect to vocational services) implications are discussed. Finally, this study formally introduces the concept that "advantaged" socioeconomic status may confer paradoxical disadvantage in coping with the vocational losses consequent to schizophrenia.

Adult↗
PubMedDate not supplied

[Dietary habits in primary school children. Role of school meals and parents's social class].

Present paper reports the results of a survey on dietary habits of 1,398 children attending first class of primary school in Trento Province (northern Italy). The following items were investigated: frequency of breakfast and foods intake; frequency of foods at school. The consumption of tracer foods as vegetables, fruit and sweets was also investigated. The results were analyzed according gender, area of residence, teaching method (full time or not) and educational level of parents. The data about nutritional style are satisfactory even if they are strongly associated to education level of parents, above all of the mother. The adequacy of nutritional style is increasing with the increasing of education level. School meal, offering selected foods to all children attending full time teaching section, can re-equilibrate nutritional style, decreasing the differences associated to education level of the parents. Present data can be used for implementing and improving health promotion action on correct dietary habits in childhood, keeping count of the role of education level of the parents.

Child↗
PubMed1975

Social class and preschool language skill. I. Introduction.

This series of studies concerns the relative validity of two explanations of why children of parents of poverty do poorly in school. Both explanations assume that nearly all children have the genetic potential to learn what the schools attempt to teach. One holds that children, and especially the black children, of poverty are in no way deficient in cognitive and linguistic skills. They fail merely because they enter school with a dialect differing from standard English. This complicates the task of learning to read in standard English. The other view holds that the rearing conditions in families of poverty limit the number and variety of objects and places and action models with which the poor child becomes acquainted during his infancy and preschool years, resulting in a cognitive deficit. These conditions also hamper the poor child's acquisition of phonemic symbols for objects and places and the relationships among them, resulting in a deficit in semantic mastery. This series of studies employs several strategies of investigation. This paper indicates their nature. It also describes in some detail the economic and educational characteristics of the parents of the two sets of children examined.

Black or African American↗
PubMed1975

Social class and preschool language skill: IV. semantic mastery of shapes.

Sociolinguists have contended that children, and especially black children, from families of poverty commonly fail in school not because they have either a cognitive or language deficit but because they have a dialect problem. Being unfamiliar with standard English, they are forced to undertake a double task while learning to read. In order to test the validity of this contention, 54 Head Start and 33 nursery-school children of four years were examined with a test of shape identification. The children of Head Start identified six shapes perceptually by matching them about as well as did the nursery-school children. On the other hand, a much smaller percentage of Head Start than of nursery school named correctly all the shapes as they were indicated by the examiners or indicated correctly all the shapes when they were named by the examiners. Sex differences in semantic mastery of shapes are absent; and among the children of Head Start, race differences in semantic mastery of shapes are also absent. The deficit in semantic mastery for shapes is clearly evident, and demonstrating the existence of such deficits can be useful in guiding compensatory education.

Child, Preschool↗
PubMedDate not supplied

Social class and the occurrence of traffic injuries and deaths in urban children.

This paper examines motor vehicle traffic accident deaths and injuries to pedestrians and bicyclists (ICD-9 codes E813-E814) aged 0-14 years, by income quintile of area of residence. It is based on 92 deaths in urban Canada in 1981, 69 deaths in Montreal during the period 1979-1983, and 1,133 injuries which resulted in hospital care or police reports in Montreal in 1981. For injuries in Montreal, the pattern of socio-economic inequality in the annual incidence rates by quintile was very pronounced, completely regular and highly significant. The rate of injury to children living in the poorest neighbourhoods was four times that of children living in the least poor neighbourhoods. For both sexes, inequalities were much more pronounced for pedestrians compared to bicyclists. For deaths in Montreal and all of urban Canada, the inequality in the rates did not follow such a consistent pattern across the income quintiles, nor were the differences statistically significant in most cases, but the rates for each sex were consistently highest in the poorest income quintile. Socio-economic inequalities in the rates of death and injury were greater in girls than in boys. The results are discussed in the context of theories of etiology and strategies for prevention.

Accidents, Traffic↗
PubMed2002

Eating attitudes in English secondary school students: influences of ethnicity, gender, mood, and social class.

OBJECTIVE: To examine the effects of ethnicity, gender, socioeconomic position, self-esteem, and emotion on eating attitudes in adolescents. METHOD: Questionnaire survey of 722 students in two English schools, using Eating Attitude Test-26 (EAT), Rosenberg Self-Esteem Scale, and Angold vMood and Feeling instruments. RESULTS: EAT scores were significantly higher for Asians and Muslims and for mixed-race subjects than for White or African Caribbean subjects (p =.003). Adjusted odds ratios for having a very high EAT score (>20) were 2.4 (95% confidence interval [CI] 1.0-6.0) in Asians and Muslims and 2.9 (95% CI 1.3-18.6) in mixed-race subjects, compared with White subjects. Having only one parent employed was also independently associated with a very high EAT score, compared with having both parents employed. Similar associations were found for a moderately high EAT score (>10) and for a combination of low self-esteem and high EAT score. Low self-esteem and depressed mood were independently associated with a high EAT score. DISCUSSION: Ethnicity, socioeconomic position, self-esteem, and depression, but not gender, were independently associated with eating attitudes. Effects of cultural and socioeconomic stresses on eating disorders may be mediated through depressed mood and low self-esteem.

Adolescent↗
PubMed2005

The obesity epidemic in young men is not confined to low social classes--a time series of 18-year-old German men at medical examination for military service with different educational attainment.

OBJECTIVE: Obesity prevalence is increasing worldwide and obesity is associated with low education. To assess if the overall increase of obesity prevalence is due to increasing obesity prevalence among low educated strata only. DESIGN: Data on n=1,883,783 males in their 19th year of life seen at physical examinations due to general conscription in Germany from 1989 to 1998. MEASUREMENTS: Stature and weight were measured in underpants and obesity defined as body mass index > 30 kg/m(2). RESULTS: From 1989 to 1998 an increase of body mass index values >70th percentile was observed. Overall obesity prevalence increased from 3.4% (95% CI 3.3-3.5) to 5.7% (95% CI 5.6-5.8). During the whole observation period, the prevalence of obesity was inversely related to educational level. The increase of obesity prevalence, however, was unrelated to educational level: for education less than 10 y from 4.9% (95% CI 4.7-5.0) to 7.7% (95% CI 7.5-7.9), for education of 10 y from 2.6% (95% CI 2.5-2.7) to 5.3% (95% CI 5.1-5.5) and for education of more than 10 y from 1.6% (95% CI 1.4-1.8) to 3.4% (95%CI 3.2-3.5). CONCLUSION: Prevalence of obesity increased among recruits of all educational levels, suggesting that preventive measures against obesity have to target all educational levels.

Adult↗
PubMed2001

Self rated health: Is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes?

STUDY OBJECTIVE: To analyse the predictive power of self rated health for mortality in different socioeconomic groups. DESIGN, SETTING, PARTICIPANTS: Analysis of mortality rates and risk ratios of death during follow up among 170 223 respondents aged 16 years and above in the Swedish Survey of Living Conditions 1975-1997, in relation to self rated health stated at the interview, by age, sex, socioeconomic group, chronic illness and over time. MAIN RESULTS: There was a strong relation between poor self rated health and mortality, greater at younger ages, similar among men and women and among persons with and without a chronic illness. The relative relation between self rated health and subsequent death was stronger in higher than in lower socioeconomic groups, possibly because of the lower base mortality of these groups. However, the absolute mortality risk differences between persons reporting poor and good self rated health were similar across socioeconomic groups within each sex. The mortality risk difference between persons reporting poor and good self rated health was considerably higher among persons with a chronic illness than among persons without a chronic illness. The mortality risk among persons reporting poor health was increased for shorter (<2 years) as well as longer (10+ years) periods of follow up. CONCLUSIONS: The results suggest that poor self rated health is a strong predictor of subsequent mortality in all subgroups studied, and that self rated health therefore may be a useful outcome measure.

Adolescent↗