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PubMed2006

Sociodemographic factors in chronic leg ulceration.

BACKGROUND: While there is a commonly held belief that leg ulceration is associated with social factors, the evidence to support this is mainly anecdotal. OBJECTIVES: To determine deficits in sociodemographic status in patients with chronic leg ulceration. In a matched case-control study carried out in community leg ulcer clinics and participants' homes within Wandsworth Primary Care Trust, patients with chronic leg ulceration were compared with age- and sex-matched community controls drawn from general practitioner registers. Main outcome measures were the prevalence of social class, ethnicity, marital status, living status and social support. Data were analysed by conditional logistic regression. RESULTS: In all, 113 patients were identified and matched to controls. Patients had a mean age of 75 years (range 31-94), with 72 (64%) being women. The ulcer had been present for a median of 8 months (range 0.8-144), and 29% of patients had an area of ulceration >10 cm(2) (range 0.5-171.5). Being Afro-Caribbean increased the risk of leg ulceration eightfold (95% confidence interval, CI 1.83-34.75; P < 0.001) compared with the white population. There was a gradient with social class, with patients with leg ulcers being more likely to come from social class IV and V (odds ratio, OR 2.82, 95% CI 1.19-6.74; P = 0.015). Never having married (OR 2.98, 95% CI 1.15-7.74; P = 0.025), living in rented housing (P < 0.001) and having a mobility deficit (P < 0.001) more often occurred in the ulcer patients, while living with a spouse was protective (OR 0.46, 95% CI 0.21-0.99; P = 0.048). Patients with ulceration experienced significantly poorer social support than their controls for most subscales of the medical outcomes study social support questionnaire (all P < 0.05). CONCLUSIONS: Chronic leg ulceration is associated with poorer socioeconomic status, and factors which relate to social isolation. At present it is not possible to determine whether these associations are causative or are a consequence of the ulceration.

Adult↗
PubMedDate not supplied

Estimation and comparison of significant caries index and the pattern of sugar consumption among 12-year-old school going children of two different socioeconomic strata.

The purpose of this study was to estimate and compare the Significant Caries Index (SiC), the pattern of sugar consumption, and to know the oral hygiene practices in a sample of 200, 12-year-old school going children of two different social classes residing in both urban and rural areas. The subjects were divided into two social classes based on the per capita monthly income. Twenty-four hour dietary records of five consecutive days were obtained from each subject. The results showed that all the subjects brushed daily. More number of children belonging to social class I and urban area brushed twice a day. While there were no significant differences in DMFT among the study groups, SiC index was higher in males, subjects of social class I, and urban residents. Sweet score, Total sugar exposure and Between-meal sugar exposure were more in males, subjects of social class I, and urban residents, whereas At-meal sugar exposure was more in females, subjects of social class II, and rural residents. From a preventive point of view, males, subjects of higher socioeconomic background, and urban residents seem to be the most important target groups for dental health communication programs focusing on the frequency of sugar consumption and dietary counselling.

Child↗
PubMed2005

Environmental equity, air quality, socioeconomic status, and respiratory health: a linkage analysis of routine data from the Health Survey for England.

STUDY OBJECTIVE: To assess relations between socioeconomic status and local air quality, and combined effects on respiratory health, in the context of environmental and health inequality. DESIGN: Data on people taking part in the Health Survey for England were attributed with a small area index of air pollution using annual mean concentrations of nitrogen dioxide, sulphur dioxide, benzene, and particulates (PM10). Regression models were used to measure associations between social class, air quality, forced expiratory volume in one second (FEV1), and self reported asthma. PARTICIPANTS: Participants aged 16-79 in the Health Survey for England 1995, 1996, and 1997. MAIN RESULTS: Urban lower social class households were more likely to be located in areas of poor air quality, but the association in rural areas was, if anything reversed. Low social class and poor air quality were independently associated with decreased lung function (FEV1), but not asthma prevalence, after adjustment for a number of potential confounders. Social class effects were not attenuated by adjustment for air quality. In men, a differential effect of air pollution on FEV1 was found, with its effect in social classes III to V about double that in social classes I and II (p value for interaction = 0.04). This effect modification was not seen for women. CONCLUSIONS: Further evidence of environmental inequity in the UK is provided. The association between FEV1 and local air quality is of similar magnitude to that with social class, and the adverse effects of air pollution seem to be greater in men in lower social classes.

Adolescent↗
PubMed2006

Association of childhood socioeconomic position with cause-specific mortality in a prospective record linkage study of 1,839,384 individuals.

Previous studies have lacked sufficient power to assess associations between early-life socioeconomic position and adult cause-specific mortality. The authors examined associations of parental social class at age 0-16 years with mortality among 1,824,064 Swedes born in 1944-1960. Females and males from manual compared with nonmanual childhood social classes were more likely to die from smoking-related cancers, stomach cancer, respiratory disease, cardiovascular disease, and diabetes. Males from manual compared with nonmanual social classes were more likely to die from unintentional injury, homicide, and alcoholic cirrhosis. The association with stomach cancer was little affected by adjustment for parental later-life and own adult social class or education. For other outcomes, educational attainment resulted in greater attenuation of associations than did adjustment for adult social class. Early-life social class was not related to suicide or to melanoma, colon, breast, brain, or lymphatic cancers or to leukemia. With the exception of stomach cancer, caused by Helicobacter pylori infection acquired in childhood, poorer social class in early life was associated with diseases largely caused by behavioral risk factors such as smoking, physical inactivity, and an unhealthy diet. Educational attainment may be important in reducing the health inequalities associated with early-life disadvantage.

Cause of Death↗
PubMed1990

Genetic and early environmental components in sociodemographic influences on adult body fatness.

OBJECTIVE: To explore genetic and environmental contributions to the influence of parental social class and region of upbringing on adult human fatness. DESIGN: Survey of sample of adults who had been adopted in childhood to relate their body mass index to sociodemographic variables in a series of multiple linear regression analyses. SUBJECTS: 4643 Subjects traced from a register of 5455 non-familial adoptees registered in 1924-47, of whom 3651 gave details of current height, weight, and occupation. The final sample totalled 2015 adoptees for whom there was also information on their region of upbringing and on the social class of their adoptive and biological fathers. MAIN OUTCOME MEASURES: Age, sex, body mass index, social class (of adoptee and adoptive and biological father), and geographical region. RESULTS: There was a significant inverse relation of adoptees' body mass index with their own social class and that of both their biological and adoptive fathers. Adoptees raised in provincial areas had a significantly greater body mass index than did those raised in Copenhagen. A multivariate regression model, including age, sex, and social class of the adoptee, confirmed the significant independent influence of the social class of both adoptive and biological fathers and of region of rearing on adoptees' body mass index. CONCLUSION: Both familial environmental and genetic factors contribute to the relation of parental social class to adult fatness, and they are partly independent of the effect of an individual's own social class. The influence of region of upbringing on adult fatness is of environmental origin and is independent of social class characteristics.

Adoption↗
PubMed1990

Prevalence of iron deficiency in rural pre-school children in Northern Ireland.

Screening for iron deficiency was offered to 485 pre-school children in one practice. A questionnaire asking for details of the child's birth, diet, medical history and social status was sent to all the families of these children. Three hundred and eleven children (64% of the total) had blood samples taken for haemoglobin concentration, mean corpuscular volume and serum ferritin levels. Fifty four of the children (17%) were iron deficient (serum ferritin less than 10 micrograms l-1 or mean corpuscular volume less than 75 fl), while 10 (3%) had iron deficiency anaemia (haemoglobin level less than 10.5 g dl-1). The prevalence of iron deficiency and iron deficiency anaemia were not significantly associated with any social class. However, there was a higher prevalence among social class 3 children than children from other social classes, 29% of them having covert iron deficiency, while 6% were frankly anaemic. As there are no ethnic minorities in the practice, dietary inadequacy was likely to be the main cause of iron deficiency. After receiving iron supplements for up to three months, all the children who were iron deficient or anaemic and attended for follow up had normalized blood values. In view of the high prevalence of iron deficiency throughout the social classes, and its association with developmental delay and behavioural disorders, screening will be offered to all children when they attend for measles, mumps and rubella immunization, and those who do not attend will be followed up.

Anemia, Hypochromic↗
PubMed1983

Dimensions of experience.

Life-event data for a 3-month period were collected for 1058 adults. Six ways of categorizing life events and difficulties were analysed: namely, loss (L), threat (T), anti-social act (A), hopeless situation (H), uncertainty of outcome (U), and choice of action (C). Reliabilities were moderate to good. The number and the pattern of characteristics within a single event or difficulty were found to be the most important elements in predicting a depression score criterion. Two patterns were particularly predictive: CH present in an event or difficulty, and LH present with U absent. Approximately 21.9% of the depression score variance may be explained using life events together with the respondent's social class, sex and social support. This represents a significant improvement over prediction based solely on the scoring methods of Brown & Harris (1978).

Anxiety↗
PubMed1995

The balance of exchange in instrumental support with network members outside the household.

The exchange of six types of instrumental support with individuals outside the household was examined using data from the 1990 Canadian General Social Survey. The balance of exchange within the network as a whole was considered in relation to age, gender, social class, availability of social relationships, and health status. The findings reveal the complexity of examining the provision and receipt of support simultaneously. Results are generally consistent with propositions under exchange theory regarding the association between age and reciprocity, depending on assumptions made about the nature of exchange. Implications for future research are discussed.

Adolescent↗
PubMed1989

Social network and regular dental care utilisation in elderly men. Results from the population study "Men born in 1914", Malmö, Sweden.

In connection with an extensive examination of their health status, a representative sample of 68-year-old men (n = 621) in the city of Malmö, Sweden, were interviewed in detail regarding different aspects of the social network, social support and social influence of the individual, dental care utilisation and perceived dental health. 79% of the dentate and 7% of the edentulous subjects made regular dental visits. The most important reason for not visiting a dentist regularly was "no perceived need". Social class and different aspects of social network and social support were in univariate analyses associated with regular dental care. In the multivariate analysis, social anchorage and social participation, subconcepts of the social network, and social class showed independent associations with regular dental care. The addition of the social network and social support variables yielded a more differentiated and thereby a more valid picture of the determinants of regular dental care utilisation. These factors should therefore be considered when public health efforts to increase the number of elderly persons receiving regular dental care are made.

Aged↗
PubMedDate not supplied

Secular trends in stature in Poland: national and social class-specific.

Mean statures of Polish 19-year-old males, as estimated from large national random samples of conscripts examined at 10-year intervals, increased from 170.5cm in 1965 to 176.9cm in 1995. The average statural gain of 2.1 cm per decade is rather high compared to other European countries, although not exceptionally so. In addition, secular trends were analysed separately for each of seven selected social groups, each group comprising subjects equated for three social criteria. The rank-order of the seven groups on the statural scale has remained identical throughout the period considered, although the group-specific trends have not been strictly parallel. During the period 1965 1986 there has been a tendency for the groups lowest on the social and statural scale to diminish their statural distance from the social elite, the sons of the large-city intelligentsia, a social group consistently the tallest of all the seven groups considered. However, that tendency for the social gaps to narrow came to a halt during the last, 1986-1995, decade. The present time-lag, in stature, of the group lowest on the social scale, the peasants, behind the social elite amounts to almost 30 years. These findings assume special significance in view of: (1) the high ethnic homogeneity of the population of Poland; (2) the absence in that population of any social-class differences in gene frequencies; and (3) certain peculiarities of Poland's post-war economic and political history.

Adolescent↗
PubMedDate not supplied

Age variation in Hodgkin's disease risk factors in older women: evidence from a population-based case-control study.

Hodgkin's disease (HD), which affects all age groups, has been associated with childhood social class, particularly among adults under age 40. Little is known about social class risk factors in older adults, and the few existing studies have conflicting findings. As part of a population-based case-control study of HD in women, we examined social class risk factors by diagnostic age groups (45-54 years and 55-79 years) corresponding to incidence patterns and by histologic subtypes based on a uniform pathologic review. Among women ages 45-54, cases were more likely to be Catholic, to have lower income and to be taller than controls. Among women ages 55-79, cases tended to have come from small or large childhood households, lived in single-family childhood housing, and had a single rather than shared bedroom at age 11. For the nodular sclerosis (NS) histologic subtype, similar age differences in risk factors were apparent. Comparisons between the NS and non-NS subtypes in women ages 55-79 identified some common risk factors (single-family childhood home, single bedroom at age 11) but others specific to one subtype (childhood household size, adult height for NS; lower maternal education for non-NS). Thus, some social class associations with HD differed between middle-aged and older women, as well as between these groups and younger adults, while others were shared across age groups. Risk also was associated with both higher and lower childhood social class in middle-aged and older women, in contrast with previous findings. None of these patterns was explained entirely by histologic subtype but may reflect age and histology subtype variation in the HD-EBV association.

Age Factors↗
PubMed1985

Alcohol consumption and alcoholism in an urban population in central Sweden.

A representative selection of 2,283 individuals, 18-65 years old, in "former" Stockholm County, were examined by psychiatrists in 1970-71. The total of non-participants was 12%. The alcohol consumption pattern and the prevalence of the diagnosis alcoholism for the last 12 months are reported. Significantly more men than women confirmed "very high" and "high" consumption, respectively. The diagnosis alcoholism was given to 4.8% men and 1.4% women. Significantly more women in social class I than in II and III, as significantly more men in social class I than in II stated "very high" or "high" consumption. Social consequences of alcohol consumption, in the form of entries in the Penal Register of the National Board of Excise (Kontrollstyrelsens straffregister) for the years 1965-71, were, on the other hand, found significantly more frequently among men in social class III than in social classes I and II.

Adolescent↗
PubMed1996

Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood.

OBJECTIVE: To investigate strength of associations between risk factors for cardiovascular disease and socioeconomic position during childhood and adulthood. DESIGN: Cross sectional analysis of status of cardiovascular risk factors and past and present social circumstances. SUBJECTS: 5645 male participants in the west of Scotland collaborative study, a workplace screening study. MAIN OUTCOME MEASURES: Strength of association between each risk factor for cardiovascular disease (diastolic blood pressure, serum cholesterol concentration, level of recreational physical exercise, cigarette smoking, body mass index, and FEV1 score (forced expiratory volume in one second as percentage of expected value) and social class during childhood (based on father's main occupation) and adulthood (based on own occupation at time of screening). RESULTS: All the measured risk factors were significantly associated with both father's and own social class (P < 0.05), apart from exercise and smoking (not significantly associated with father's social class) and body mass index (not significantly associated with own social class). For all risk factors except body mass index, the regression coefficient of own social class was larger than the regression coefficient of father's social class. The difference between the coefficients was significant for serum cholesterol concentration, cigarette smoking, body mass index, and FEV1 score (all P < 0.001). CONCLUSIONS: Subjects' status for behavioural risk factors (exercise and smoking) was associated primarily with current socioeconomic circumstances, while status for physiological risk factors (serum cholesterol, blood pressure, body mass index, and FEV1) was associated to varying extents with both past and present socioeconomic circumstances.

Adult↗
PubMed1986

Life satisfaction in old age: linking social psychology and history.

A life course perspective on aging assumes that adaptation is governed by factors beyond the immediate situation. Using longitudinal data on 79 women from the 1900 generation of the Berkeley Guidance Study, we examined how social and psychological factors interact over time in the course of successful aging, as expressed by life satisfaction. The consequences of adaptive resources in early adulthood vary in relation to social class. Intellectual skills in 1930 indirectly predict life satisfaction in old age for women from the working class, whereas emotional health is more influential in the life satisfaction of women with higher class origins. Social activity in old age makes a difference only in the lives of women from the working class. Finally, adaptation to old age is related to women's experiences with past stressful events. Middle-class women in 1930 showed gains attributable to Depression hardship (1930s), whereas the life satisfaction of women from the working class was diminished by such hardships. Several mechanisms are discussed that may link widely separated problem situations and life events across the life course. The analysis provides empirical support for the proposition that the influence of social change on life trajectories is contingent on what individuals bring to change situations.

Adaptation, Psychological↗
PubMed1990

Antisocial behaviour and postnatal environment: a French adoption study.

The higher rate of antisocial behaviour in children from lower class environments has been hypothesized as arising from (a) genetic social class differences and/or (b) cultural/environmental disadvantages. The present study aims to evaluate the strength of the incidence of social class on adolescent antisocial behaviour. To separate genetic factors and the prenatal environment from postnatal rearing conditions, 77 children relinquished at birth and adopted before the age of 3 were studied. Using the Rutter "Children's Behaviour Questionnaire for Completion by Teachers", eight antisocial behaviours were assessed when subjects were in late adolescence. With the exception of theft and bullying, results indicate that the higher the adoptive parental social class, the lower the antisocial behaviour rates in the adoptees. It is shown that the relationship between the total score of adoptees' antisocial behaviour and social class cannot be attributed exclusively to a concentration of these behaviours in the lowest class. No significant selective placement was observed. Concordances and discrepancies with previous studies are discussed.

Adolescent↗
PubMed2003

Adverse social factors predict early ageing in middle-aged men and women: the Ebeltoft Health Study, Denmark.

AIMS: This study examined whether adverse social factors are associated with an increased rate of biological ageing in middle-aged subjects. METHODS: The authors investigated five markers of biological ageing in 690 subjects followed for five years in Ebeltoft, Denmark. Mean age at baseline was 40 years (range 30-50 years). These markers included repeated measures of pulse pressure, lung function, hearing, physical work capacity and a cardiovascular risk score. A zeta-score was calculated based on a factor analysis of the five markers used. The relative biological age was finally calculated in relation to chronological age in subgroups of different social class (occupation, educational level) and marital status, at baseline and after follow-up. RESULTS: Men and women from a higher social class appeared to be biologically younger than corresponding subjects from a lower social class (p < 0.001). This difference was still evident after 5 years of follow-up (p < 0.01) for men and women of different occupations and for women of different educational levels (p < 0.01). Married/cohabiting men were biologically younger than single men and this difference increased during the follow-up period in that the difference between groups at five-year follow-up was significant (p < 0.05). CONCLUSIONS: Middle-aged men and women from a higher social class showed signs of being biologically younger than their corresponding chronological age, while the opposite was found for men and women of lower social class. This discrepancy was still evident after five years of follow-up, and even tended to increase for single men. Differential ageing may thus be an important biological aspect of differences in health according to social class.

Adult↗
PubMed2000

Comparing health inequality in men and women: prospective study of mortality 1986-96.

OBJECTIVES: To study prospectively the differences in health inequality in men and women from 1986-96 using the Office for National Statistics' longitudinal study and new socioeconomic classification. To assess the relative importance of social class (based on employment characteristics) and social position according to the general social advantage of the household to mortality risk in men and women. DESIGN: Prospective study. SETTING: England and Wales. SUBJECTS: Men and women of working age at the time of the 1981 census, with a recorded occupation. MAIN OUTCOME MEASURES: Mortality. RESULTS: In men, social class based on employment relations, measured according to the Office for National Statistics' socioeconomic classification, was the most important influence on mortality. In women, social class based on individual employment relations and conditions showed only a weak gradient. Large differences in risk of mortality in women were found, however, when social position was measured according to the general social advantage in the household. CONCLUSIONS: Comparisons of the extent of health inequality in men and women are affected by the measures of social inequality used. For women, even those in paid work, classifications based on characteristics of the employment situation may give a considerable underestimate. The Office for National Statistics' new measure of socioeconomic position is useful for assessing health inequality in men, but in women a more important predictor of mortality is inequality in general social advantage of the household.

Age Distribution↗
PubMed1985

Attempted suicide in Denmark. I. Some basic social characteristics.

During a 6 months' period, 99 persons, randomly chosen among patients admitted for attempted suicide to the Department of Psychiatry, Odense University Hospital, were interviewed. This paper, which is the first in a series, deals with the theoretical and methodological background of the survey and the validity of the sample and also with some basic social characteristics of the suicide attempters. The majority of the suicide attempters were found to be single and many of them were living alone or alone with children. The sample could also be characterized by a low level of vocational education and by lack of association with the labour market. The suicide attempters could not, however, be unequivocally described as being in bad financial circumstances, neither were they solely from the lower social classes; the social status profile of the suicide attempters was closer to the status profile of suiciders, with relatively many persons from both upper and lower classes and few from the middle class.

Adolescent↗