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At least 1,531 records · Page 85Linked to original sources
PubMed1994

Childhood eczema: disease of the advantaged?

OBJECTIVE: To determine whether the increased prevalence of childhood eczema in advantaged socioeconomic groups is due to increased parental reporting. DESIGN: Comparison of parental reports of eczema with visible eczema recorded by medical officers during a detailed physical examination. SETTING: National birth cohort study. SUBJECTS: 8279 children from England, Wales, and Scotland born during 3-9 March 1958 and followed up at the ages of 7, 11, and 16. MAIN OUTCOME MEASURES: Prevalence of eczema according to parental report compared with medical officer's examination at the ages of 7, 11, and 16. RESULTS: Prevalence of both reported and examined eczema increased with rising social class at the ages of 7, 11, and 16 years. The point prevalence of examined eczema at age 7 was 4.8%, 3.6%, 3.6%, 2.4%, 2.2%, and 2.4% in social classes I, II, III non-manual, III manual, IV, and V respectively (chi 2 value for linear trend 12.6, P < 0.001). This trend persisted after adjustment for potential confounders such as region and family size and was not present for examined psoriasis or acne. CONCLUSIONS: Eczema is more prevalent among British schoolchildren in social classes I and II than those in lower classes. Exposures associated with social class are probably at least as important as genetic factors in the expression of childhood eczema.

Adolescent↗
PubMed1996

Physical activity at work and the risk of chronic pancreatitis.

OBJECTIVE: To examine the hypothesis that low social status in chronic pancreatitis is accounted for by high physical activity at work. DESIGN: A case-control study comparing 50 patients with an established diagnosis of chronic pancreatitis with 100 age- and sex-matched community controls. RESULTS: There was a significant association between a high level of physical activity and chronic pancreatitis risk, the relative risk being 3.9 (1.3-11.7). After controlling for age, sex, smoking and alcohol intake, a high amount of calorie expenditure during work was still significantly associated with chronic pancreatitis risk, the relative risk being 4.5 (1.2-17.7). When social class was controlled for physical activity the increased risk for low social class status disappeared. CONCLUSION: This study suggests that the social class gradient may be explained by the amount of manual labour.

Adult↗
PubMed2004

Socio-economic differences in cardiovascular disease and physical activity: stereotypes and reality.

Cardiovascular disease (CVD) is patterned by socio-economic status, being more common in lower social classes. Since physical inactivity is a risk factor for CVD it might be assumed that it is more common in lower social classes. We examine major recent UK population surveys and show that this assumption is incorrect; although higher social class adults engage in more formal sports activities, they are less likely to engage in other (e.g. occupational) activities. Lower social class children are more likely to engage in sports and active play. We also show that although Scotland has higher rates of CVD than England, it does not have higher prevalences of all CVD risk factors.

Adolescent↗
PubMedDate not supplied

The association of social status and blood pressure with markers of vascular inflammation.

OBJECTIVE: Low socioeconomic status (SES) is associated with low-grade inflammation. Vascular inflammation often accompanies high blood pressure (BP) and has clinical implications for future vascular diseases, including atherosclerosis. Elevated plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) and endothelin-1 (ET-1) are reliable indicators of vascular inflammation. We examined the associations among BP, social status, and sICAM-1 and ET-1 levels in 121 European American and African American men and women. METHODS: Social status of the subjects was determined by using the Hollingshead Two Factor Index of Social Position scale, and plasma sICAM-1 and ET-1 levels were assessed using immunoassays. RESULTS: Correlation analyses revealed positive correlations among plasma sICAM-1 levels, BP, and social status. Levels of ET-1 were also significantly correlated with BP (p < .01) and social status (p < .001). When subjects were categorized into three social classes, sICAM-1 levels were significantly higher in the lowest social class as compared with the upper (p < .05) or middle (p < .01) class. The levels of ET-1 were higher in the low (p < .01) and middle (p < .05) social classes as compared with the upper class. Multiple hierarchic regression analyses revealed that even after controlling for demographic and health characteristics (gender, ethnicity, age, body mass index, and smoking) and systolic BP, social status accounted for additional variance of sICAM-1 or ET-1 levels. CONCLUSION: These results suggest that low-social-status individuals may incur risk for future vascular diseases through vascular inflammation.

Adult↗
PubMed1996

Measuring social inequalities in health in the United States: a historical review, 1900-1950.

For over two centuries, U.S. vital statistics routinely have been stratified by age, sex, and race, but not by social class. The usual explanation is that U.S. government officials have not considered social class relevant to health. During the first third of the 20th century, however, questions of socio-economic inequalities in morbidity and mortality ranked high on the agenda of federal and other public health agencies, and routine reporting of U.S. vital statistics and health survey data by socioeconomic measures was nearly institutionalized. This history has largely been lost. In this article, the authors focus on the period from 1900 to 1950 and examine how public health researchers and agencies conceptualized and analyzed socioeconomic inequalities in health. Highlights include production, for 1930, of the first U.S. national death rates stratified by social class, in work sponsored by the National Tuberculosis Association and Bureau of the Census, and the Public Health Service's 1935-1936 National Health Survey, which reported morbidity data stratified by socioeconomic measures. Efforts like these were cut short by the onset of World War II and their legacy erased by the Cold War. Recovering this rich history can help inform current debates about collecting and evaluating data on social inequalities in health.

Health Status↗
PubMed2005

Social inequalities in the impact of flexible employment on different domains of psychosocial health.

STUDY OBJECTIVES: (1) To analyse the impact of flexible employment on mental health and job dissatisfaction; and (2) to examine the constraints imposed by flexible employment on men's and women's partnership formation and people's decision to become parents. For the two objectives the potentially different patterns by sex and social class are explored. DESIGN: Cross sectional health survey. Multiple logistic regression models separated for sex and social class (manual and non-manual workers) and controlling for age were fitted. Four types of contractual arrangements have been considered: permanent, fixed term temporary contract, non-fixed term temporary contract, and no contract. SETTING: Catalonia (a region in the north east of Spain). PARTICIPANTS: Salaried workers interviewed in the 2002 Catalonian health survey with no longstanding limiting illness, aged 16-64 (1474 men and 998 women). MAIN RESULTS: Fixed term temporary contracts were not associated with poor mental health status. The impact of other forms of flexible employment on mental health depended on the type of contractual arrangement, sex, and social class and it was restricted to less privileged workers, women, and manual male workers. The impact of flexible employment on living arrangements was higher in men. Among both manual and non-manual male workers, those with fixed term temporary contracts were less likely to have children when married or cohabiting and, additionally, among non-manual male workers they also were more likely to remain single (aOR = 2.35; 95%CI = 1.13 to 4.90). CONCLUSION: Some forms of temporary contracts are related to adverse health and psychosocial outcomes with different patterns depending on the outcome analysed and on sex and social class. Future research should incorporate variables to capture situations of precariousness associated with flexible employment.

Adolescent↗
PubMed1980

Asthma and bronchitis in Sydney schoolchildren. II. The effect of social factors and smoking on prevalence.

During a study of the prevalence of asthma and bronchitis in Sydney schoolchildren, some social and environmental factors were documented to ascertain if these affected the prevalence of either of these diseases. Socioeconomic status obtained from father's occupation, area of residence, family size, nationality, country of birth and smoking habits were examined. Although small differences were found between groups, no consistent relationship was found between social class and lung disease with the exception of increased prevalence of asthma in boys in social class I and girls in social class II. There were no major associations with area of residence or with family size. Children who were born outside Australia tended to have less asthma and bronchitis than children born inside Australia and migrant children tended to first develop asthma several years after arriving in Australia. Bronchitis was found to be more common in children with an earlier history of bronchitis in infancy and early childhood. The prevalence of recent bronchitis in the group of children who smoked 20 or more cigarettes per week was higher than that in the nonsmoking group of children.

Adolescent↗
PubMed1992

Social inequities in cardiovascular disease risk factors in East and West Germany.

Social class related differences in prevalence of cardiovascular disease risk factors in Germany were investigated with special emphasis on comparisons between East and West Germany and on time trends. Databases for West Germany are the first and second National Health Survey (survey 1: N = 4794, survey 2: N = 5315), carried out in the framework of the German Cardiovascular Prevention Study, and for East Germany the first GDR-MONICA project (N = 6125). Different social class indices were applied to evaluate social inequities for hypertension, hypercholesterolemia, cigarette smoking, obesity and predicted cardiovascular disease mortality. As a main result, it was found that very similar patterns in the relation between social class characteristics and cardiovascular disease risk factor prevalence occurred for both parts of Germany. Social class gradients were strongest for obesity and weakest for hypercholesterolemia. Analysis of time trends for the period from 1984 to 1988 (for West Germany only) revealed an increase in social inequalities for hypertension in males and cigarette smoking in females. These findings point to the need to focus more on social disadvantaged segments in the population when community based health promotion and disease prevention programs are brought into action.

Adult↗
PubMed1978

Infant antecedents of cognitive functioning: a longitudinal study.

A follow-up investigation of 35 boys and 33 girls 10 years old who had been assessed originally at 4, 8, 13, and 27 months old did not reveal strong relations between infant variables such as attentiveness, vocal excitability, irritability or activity, on the one hand, and reflection-implusivity, intelligence quotient, or reading ability at age 10. A suggestive relation was found between assimilative smiling during infancy and a reflective attitude on the Matching Familiar Figures Test and between a slow tempo of play during infancy and longer response time on a specially constructed Embedded Figures Test at age 10. Although attentiveness during infancy predicted IQ and reading ability at age 10, both infancy and childhood variables were positively correlated with social class, suggesting that experiences associated with the social class of the parents, rather than particular infant qualities, were the more important predictors of the cognitive variables at age 10. Children with high EMG levels from the flexor forearm tended to be slightly more impulsive at age 10 and less attentive at 27 months, even when the effect of social class was removed.

Achievement↗
PubMed1976

Cost-effectiveness of two methods of screening for asymptomatic bacteriuria.

A comparison of two methods of screening schoolgirls for asymptomatic specimens of urine from 96.3, but that the home self-administered use of dipslides was successful in only 70.2%. The failure to obtain the return of satisfactory dipslides was most frequent in children under seven and over 11 years of age, and in children from the lower social classes; satisfactory dipslides were returned by 84% of children from social classes I, II, and III non-manual workers, but by only 58% of children from social class V and the unemployed. The cost per child screened was pounds 0.77 with the supervised method and pounds 0.26 with the dipslide method. An alternative supervised method which would have successfully screened 85% would have cost pound 0.55 per child screened. Using the home dipslide method, the cost per case of asymptomatic bacteriuria detected would vary from pounds 10.40 to pounds 20.00, depending on the age group screened.

Adolescent↗
PubMed2004

Malocclusions and orthodontic treatment needs in a group of Spanish adolescents using the Dental Aesthetic Index.

OBJECTIVE: To evaluate the prevalence of malocclusion and orthodontic treatment need among Spanish adolescents and compare with other populations. METHODS: The study sample comprised 744 schoolchildren from urban and rural populations in Granada province (Southern Spain), aged from 14-20 years, who had received no orthodontic treatment. The measurement instrument was the Dental Aesthetic Index (DAI). RESULTS: The mean DAI score of the whole series was 25.6 (SD, 7.94). The distribution of the four DAI grades was: DAI 1, no anomaly or malocclusion, 58.6%; DAI 2, definite malocclusion, 20.3%; DAI 3, severe malocclusion, 11.2%; DAI 4, very severe or disabling malocclusion, 9.9%. There were no statistically significant differences in DAI score between genders or those in rural vs. urban residence, but a significant difference was found between social classes, with subjects of low social class presenting the worst scores (p<0.05). CONCLUSION: The distribution of DAI scores among Spanish adolescents is similar to that reported in other populations.

Adolescent↗
PubMed2000

Social and behavioural influences on the uptake of hormone replacement therapy among younger women.

OBJECTIVE: To describe the social and behavioural influences on the uptake of hormone replacement therapy before the age of 50. DESIGN: Nationally representative birth cohort study with detailed hormone replacement therapy histories and prospective data on health, social and behavioural factors collected throughout life. SETTING: England, Scotland and Wales. POPULATION: General population sample of 1,572 women followed to the age of 50 years. MAIN OUTCOME MEASURE: Age at first hormone replacement therapy use RESULTS: By the age of 50 years, 45% of women had tried hormone replacement therapy and one third were current users. Over two-fifths of users had tried more than one preparation and over one quarter had episodic use. For the vast majority, prescribing conformed to current guidelines. More educated women took hormone replacement therapy for long term prevention compared with their less educated peers. Hysterectomy increased the chances of taking hormone replacement therapy, particularly where an oophorectomy had also been performed, and was associated with longer and more continuous use. Results of a Cox's proportional hazards model showed that the age at which first hormone replacement therapy is used by women who have not had a hysterectomy was influenced by previous contact with health services for menstrual disorders, previous use of oral contraception and cigarettes, past reporting of health problems and low social class. The relation between smoking and low social class with early use of hormone replacement therapy may be due to their association with early menopause. CONCLUSIONS: The trend over the last two decades towards greater use of hormone replacement therapy has continued unabated for younger women. So far, hormone replacement therapy users in this generation have had less healthy lifestyles and social advantages than nonusers, in contrast to many older mainly American studies based on earlier generations. This may have long term implications for health and health care as the postwar baby boom generation ages.

Adult↗
PubMed1997

Risk factors for basal cell carcinoma in the UK: case-control study in 806 patients.

Basal cell carcinoma (BCC) is the commonest malignant neoplasm in white people. We present a large UK case-control study in which conditional logistic regression analysis of age-matched and gender-matched data sets was used to compare, first, cases with controls (n = 403) and second, patients having multiple BCC with those having a single BCC (n = 278). Eye/hair colour, occupation, skin type, social class, tumour site at presentation and smoking history were assessed. Social class 1/2, skin type 1, red/blonde hair and blue/green eyes were all related to BCC risk, social class most strongly (odds ratio 2.36, P = 0.007). Truncal site at presentation was a risk factor for the development of multiple BCC (odds ratio 4.03, P = 0.002). These data support the view that genetically mediated differences in ultraviolet responsiveness are important in BCC, though the scale of their effect is small. They may be exploitable in primary and secondary prevention as well as giving insights into pathogenesis. In particular, the fact that patients presenting with a truncal tumour are at increased risk of further BCC suggests that intermittent exposure in genetically predisposed individuals may contribute to a cancer susceptibility syndrome.

Basal Cell Carcinoma↗
PubMed2001

Birth weight and cognitive function at age 11 years: the Scottish Mental Survey 1932.

AIMS: To examine the relation between birth weight and cognitive function at age 11 years, and to examine whether this relation is independent of social class. METHODS: Retrospective cohort study based on birth records from 1921 and cognitive function measured while at school at age 11 in 1932. Subjects were 985 live singletons born in the Edinburgh Royal Maternity and Simpson Memorial Hospital in 1921. Moray House Test scores from the Scottish Mental Survey 1932 were traced on 449 of these children. RESULTS: Mean score on Moray House Test increased from 30.6 at a birth weight of <2500 g to 44.7 at 4001-4500 g, after correcting for gestational age, maternal age, parity, social class, and legitimacy of birth. Multiple regression showed that 15.6% of the variance in Moray House Test score is contributed by a combination of social class (6.6%), birth weight (3.8%), child's exact age (2.4%), maternal parity (2.0%), and illegitimacy (1.5%). Structural equation modelling confirmed the independent contribution from each of these variables in predicting cognitive ability. A model in which birth weight acted as a mediator of social class had poor fit statistics. CONCLUSION: In this 1921 birth cohort, social class and birth weight have independent effects on cognitive function at age 11. Future research will relate these childhood data to health and cognition in old age.

Age Factors↗
PubMed2005

The contribution of lone parenthood and economic difficulties to smoking.

Smoking is more prevalent among lower socioeconomic status groups, among those who perceive economic difficulties and among lone mothers. Less is known of how these factors contribute to smoking independently. The aim of this study was first to examine the association between smoking and both economic difficulties and lone parenthood. We then also studied to what extent smoking among people experiencing economic difficulties and lone parenthood is due to other factors such as socioeconomic status and social relations. The data derive from surveys conducted among the employees of the City of Helsinki, Finland, in 2000 and 2001 including 6243 respondents aged 40-60 yr (response rate 68%). The measures were daily smoking, economic difficulties and family type, as well as socioeconomic status (education, occupational social class, household income, housing tenure) and social relations. The more had respondents experienced economic difficulties, the more prevalent was their smoking. Smoking among lone parents was more common than among parents living together; this was true for both men and women. After controlling for socioeconomic status and housing tenure, the association between smoking and economic difficulties, as well as that between smoking and lone parenthood, attenuated but remained statistically significant. However, after controlling for social relations the associations became stronger. Both economic difficulties and lone parenthood were associated with smoking independent of education, occupational social class, household disposable income, housing tenure or social relations for both men and women.

Adult↗
PubMed1999

Class voting, social change, and the left in Australia, 1943-96.

The relationship between class and voting choices has been the subject of controversy in recent years, especially in connection with the apparent decline of the traditional left. This paper examines class voting in Australia, focusing on three major issues: (1) changes in the overall strength of class voting (2) realignment, or changes in the relative political positions of the classes (3) the connection between the strength of class voting and support for Labor. It finds that (1) there is a decline in 'general' class voting (2) much of this decline involves a realignment of certain middle class groups, but there is no support for the popular idea that class alignments have become more complex (3) there is no connection between the strength of class voting and Labor performance. Our results cast doubt on accounts that regard the electoral difficulties of left parties as a symptom of the decline of class.

Australia↗
PubMed1988

A death-certificate case-control study of non-Hodgkin's lymphoma and occupation in men in North Carolina.

A death certificate-based case-control study was performed to investigate associations between occupation and non-Hodgkin's lymphoma (NHL) in North Carolina. Cases consisted of 501 men who died of NHL (International Classification of Diseases codes 200 and 202) during the years 1968-1970, 1975-1977, and 1980-1982. Controls were selected from other noncancer deaths, and were frequency matched for age, year of death, and race. Occupation and industry were obtained from the death certificates and coded without knowledge of case-control status. An increased risk for men in professional, technical, and managerial occupations, compared with all others, was detected among whites (OR = 2.69, 1.95-3.72). Black men classified as having "low exposures" by an occupational exposure linkage system had an odds ratio of 1.74 (0.84-3.60). Because of this finding, the occupations were ranked by social class and a statistically significant linear relationship was noted in whites, with risk increasing from lower social class to upper social class. An increased risk was also detected among whites in the rubber, plastics, and synthetics industries (p = .03), and among blacks employed in machine trades occupations (OR = 3.63, 1.32-9.97) and structural work occupations (OR = 2.38, 0.93-6.05). An increased risk was also detected for black painters (p = .02), but not for whites. There was no association found between NHL and employment in the following areas: textile industry; farming; laborers; or occupations with exposures to asbestos or benzene. The association with farming was further examined in counties with high use of pesticides and herbicides, and no increased risk of NHL was detected. Cases were more likely to live in the western part of the state than the eastern. However, NHL mortality rates provided by the North Carolina State Center for Health Statistics did not confirm the relationship.

Adult↗
PubMed1982

Incidence of treated alcoholism in north-east Scotland, Orkney, and Shetland fishermen, 1966-70.

The psychiatric case register for the north-east of Scotland has been used to calculate the rates for first contact with a diagnosis of alcoholism by fishermen and non-fishermen in the years 1966-70. In each of these years the fishermen had higher rates than non-fishermen as a whole and also higher rates than the non-fishermen from social class IV, which is the social class to which most fishermen belong. The smaller differences between the rates of fishermen and non-fishermen in 1969 and 1970 relative to 1966, 1967, and 1968 may reflect a preferential "shedding" of older alcoholic fishermen at a time when there was a greater than usual contraction in the size of the work force. Differences between the rates for fishermen and non-fishermen were also evident in the age groups 20-29, 30-39, 40-49, and 50-59, being most pronounced in the 20-29 group. The findings are consistent with fishing being an occupation with a high risk for alcoholism.

Adolescent↗