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PubMed1985

Predicting our own aggression: person, subculture or situation?

Using a self-report technique, teenaged subjects (stratified by sex and social class) were asked to report their predicted behaviour over 24 conflict scenarios involving 12 male and 12 female targets. In terms of degree of aggression predicted, there was a strong effect of situation. Towards male targets, lower middle-class subjects were more aggressive than upper middle-class subjects and males were more aggressive than females. With respect to female targets, the social class difference again appeared but there was no simple sex difference. The interaction of sex and social class indicated that lower middle-class females were most aggressive toward female targets. Cross-situational consistency was low even controlling for class and sex, indicating little support for a generalized 'aggressive personality'. The most powerful single effect was the situation being judged. Feature analysis of situations tending to produce fight vs. flight responses suggested that flight is associated with perceived high risk encounters whereas fighting is the modal response in 'fair fight' situations where the risk of injury is lower. It is suggested that impression management concerns operate only in these low risk situations.

Adolescent↗
PubMed1975

Dental attitudes and behavior related to vertical social mobility by marriage.

Following a dental examination of 5-year-old children, the mothers of 367 of them were interviewed. In 262 cases there was sufficient information relating to the social class of both the mother's husband and her father to enable the relationship between social mobility by marriage and the mother's dental attitudes and behavior to be assessed. The results showed that the views of mothers who moved from one social group to another fell between those of the mothers who were static in each of those two groups. Those mothers who were downward mobile had less favorable attitudes than those who had remained in the higher social group but more favorable than those who had always been in the lower social group. The reverse trend was found in upward mobile mothers. A notable exception to this pattern was the group who moved from social Class III into Class I or II. These mothers exhibited attitudes and behavior which were even more favorable than the static social Class I or II mothers. The similarity of these results to those of others in different fields is discussed.

Attitude to Health↗
PubMed2004

Oral habits among 7-10 year-old school children in Ibadan, Nigeria.

OBJECTIVE: To assess the prevalence of oral habits among 7-10 year-old children in Ibadan, Nigeria. DESIGN: An epidemiological survey of randomly selected school children. Criteria for social class was based on registrar general's social class. SETTING: Primary schools from different parts of Ibadan city, Nigeria. SUBJECTS: 493 school children aged 7-10 years consisting of 237(48.1%) boys and 256(51.9%) girls. MAIN OUTCOME MEASURES: Only children still actively involved in oral habits were coded positive. RESULTS: In all, 49(9.9%) of the children were involved in one type of oral habit or the other with digit sucking being most prevalent 40(8.1%). Lip sucking was observed in 6(1.2%) while 1(0.2%) had an unusual sucking habit--sucking of left forearm with resultant severe anterior open bite (10 mm). The relationship between the oral habits anterior open-bite and increased overjets were very significant statistically (p<0.01). No significant associations were noted between the habits and social class as well as Angle's classification of molar relations. None of the children examined had gone for routine dental check-ups before except for the 62(12.6%) who had previous dental consultations due to toothaches. CONCLUSION: Oral habits especially digit sucking needing management was revealed by this study and none of them had been to a dentist for help. This suggests that there is need to intensify oral health education in our environment, targeted at both parents and school children to enable them benefit from interceptive orthodontic care which has numerous advantages.

Age Distribution↗
PubMed1989

Inequalities in health within the health sector.

Mortality among men employed in the health sector was examined using data surrounding the 1971 (1970-2) and 1981 (1979-83) censuses to assess the differences between social classes in the health service and to study changes over a decade. Relative to men in England and Wales, mortality in the 1980s was significantly lower among dentists (standardised mortality ratio 66), doctors (69), opticians (72), and physiotherapists (79) and significantly higher among hospital porters (151), male nurses (118), and ambulancemen (109). Mortality from lung cancer among hospital porters (185) was more than fivefold that seen in doctors (33) and dentists (37). Ischaemic heart disease varied twofold, being lowest in dentists (60) and doctors (70) and highest in hospital porters (138). Over the decade mortality from lung cancer and ischaemic heart disease declined in all groups except hospital porters, ambulancemen, and orderlies. Most groups showed excess deaths from suicides and cirrhosis of the liver. Differences in mortality between health workers in social class I and those in social class IV widened between the 1970s and 1980s and to a greater extent than among the general population. The high mortality of some groups within the NHS, and the fact that differentials between social classes have widened more than in the general population, suggest that the NHS needs to pay more attention to the health of its own staff.

Adolescent↗
PubMed1992

Sudden infant death syndrome: does winter affect poor and rich babies equally?

STUDY OBJECTIVE: The aim was to investigate whether the winter increase in risk of sudden infant death was similar across social classes. DESIGN: This was an unmatched case-control study using routine data. SETTING: Cases and controls were selected from files holding routine birth and death certificate data for England and Wales for 1986. SUBJECTS: Cases were deaths in the first year of life occurring in the summer or the winter of 1986 with mention of sudden infant death or SIDS in the death certificate. Controls were a 1% random sample of all children born in the same year. Only children whose parents were married or living together at the time of birth registration were included. MAIN RESULTS: Data on age and season of death for cases, and on date of birth, social class of father, and birth weight were abstracted from the file. Season of birth and birth weight were treated as confounding variables. The increase in risk of SIDS in winter was calculated for each age group and social class. The winter increase in SIDS was more marked among the higher social classes for all ages, but not to a statistically significant degree: the p values for heterogeneity were 0.26 for age 0-3 months, 0.42 for 4-7 months, and 0.41 for 8-12 months. CONCLUSIONS: There is no direct association between seasonal variation in sudden infant death and social class.

Birth Weight↗
PubMed1990

[Social inequalities in child health status].

The article describes the health situation in relation to demographic and social class variables in a sample of 1,671 schoolchildren aged 11, 13 and 15 years in Denmark. The proportions assessing their health as excellent, good, fair, or poor were 47%, 39%, 13%, and 1%, respectively. 22% reported daily symptoms and 74% weekly symptoms (20% one symptom a week, 54% two or more symptoms). During one week, 50% suffered from bad moods, 37% insomnia, 30% depression, 26% headaches, 22% nervousness, 19% back pain, 14% abdominal pain, and 12% vertigo. 37% had used medical drugs during the last month, most frequently for headaches (25%), colds (11%), coughs (9%) and abdominal pain (8%). Girls showed poorer self-assessed health than boys, more symptoms and more use of medication. The youngest pupils had the most frequent symptoms and the oldest least. There were no health differences when place of residence or family composition were considered, but there were clear social class differences. Pupils from the lowest social class and pupils whose parents were not included in the social class classification (e.g. disability pensioners) had the poorest self-assessed health, the most frequent symptoms and the highest use of medication.

Child↗
PubMed1998

Social status and the quality of care for adult people with type I (insulin-dependent) diabetes mellitus--a population-based study.

UNLABELLED: The objective of this study was to assess the degree of diabetes care and education achieved for Type I (insulin-dependent) diabetes mellitus at the community level in relation to social status and to elucidate potential pathways that mediate any social class gradient. A population-based sample of 684 adults with Type I diabetes (41% women, mean +/- SD age 36 +/- 11, diabetes duration 18 +/- 11 years) in the district of North-Rhine (9.5 million inhabitants), Germany, were examined in their homes using a mobile ambulance. RESULTS: HbA1c (normal 4.3-6.1%) 8.0 +/- 1.5%, incidence of severe hypoglycaemia (injection of glucose or glucagon) 0.21 cases per patient-year; 62% of patients had participated in a structured group treatment and teaching programme for intensification of insulin therapy; 70% used 3 or more insulin injections per day, 9% were on continuous subcutaneous insulin infusion; 91% reported to have had measurements of HbA1c during the preceding year, and 80% to have had an examination of the retina by an ophthalmologist. Care was insufficient with respect to the quality of blood pressure control (70% of patients on antihypertensive drugs had blood pressure values > or = 160/95 mmHg), patient awareness of proteinuria/albuminuria (27% of patients had not heard about it) and prevention of foot complications (only 42% with a diabetes duration over 10 years had remembered to have a foot examination during the preceding 12 months). There was a pronounced social gradient with respect to micro- and macrovascular complications (prevalence of overt nephropathy 7 vs 20% for highest vs lowest quintiles of social class [OR 3.5, 95% CI 1.6-7.5, p = 0.002]) and diabetes-specific quality of life. HbA1c, blood pressure and smoking accounted for part of the association between social class and microvascular complications. The social class gradient was not due to inequality to access to health services, but to lower acceptance among low social class patients of preventive and health maintaining behaviour. In conclusion, achieved standards of care are high with respect to the implementation of intensified treatment regimens, the level of patient education achieved, treatment control and eye care, whereas areas for improvement are blood pressure control and preventive measures for foot care. A substantial social gradient in diabetes care persists despite equal access of patients to health services.

Adolescent↗
PubMed2005

Early growth and type 2 diabetes: evidence from the 1946 British birth cohort.

AIMS/HYPOTHESIS: We assessed whether low birthweight or early adiposity rebound was more strongly associated with type 2 diabetes, and whether any effect of low birthweight or early adiposity rebound was explained by adult BMI, adult height, social class of subject or of his/her father, or maternal or paternal diabetes. METHODS: Cox's proportional hazard models were used on data from the National Birth Cohort Study (the MRC National Survey of Health and Development), which was begun in 1946 and had self-reported physician-diagnosed diabetes with age at onset ranging from 31 to 53 years (n=78 cases, and n=47 cases in the multivariate analysis) as the outcome. RESULTS: A U-shaped association between birthweight and type 2 diabetes rates was close to statistical significance (quadratic term p value=0.08). Younger age at adiposity rebound was associated with increased rates of type 2 diabetes (test for trend p=0.002), the association being robust to adjustment for each of sex, birthweight, weight at 2 years, father's social class, parental diabetes, and own social class. The effect of early adiposity rebound was very slightly reduced by adjustment for sex and adult height (p=0.003), but considerably reduced after adjustment for sex and adult BMI (test for trend p=0.1), and further reduced (p=0.4) after additional adjustment for birthweight, weight at 2 years, adult height, social class of subject and of his/her father, and parental diabetes. CONCLUSIONS/INTERPRETATION: Early adiposity rebound was associated with an increased rate of type 2 diabetes independently of birthweight, but its effect was mostly through high adult BMI. Parental diabetes and possibly low weight at 2 years were also risks.

Adiposity↗
PubMed1986

Changes in skinfold thicknesses and body mass index in 171 children, initially 1 to 5 years of age: a 5 1/2-year follow-up study.

Changes in skinfold thicknesses and BMI were investigated in 171 children aged 1-5 years in 1978 and 5 1/2 years later aged 6-10 years in 1984. Tracking in skinfold thicknesses or body fatness and BMI was determined using the correlation coefficients between these variables in 1978 and 1984. Body fatness tracking was higher in girls than in boys. There were no marked differences between skinfold correlations from sites of the trunk and those from the extremities. Generally, about 50 percent of the variation in skinfold thicknesses in girls aged 6-10 years was associated with skinfold thicknesses 5 1/2 years before. In boys, only about 5 percent of the variation of skinfold thicknesses at ages 6-10 years could be explained by values 5 1/2 years before. There was no marked sex difference in BMI tracking. Initially fatter girls showed higher skinfold thickness tracking than initially leaner girls. Parental fatness level and social class were both related to changes in skinfold thicknesses. Children who became relatively fatter in 5 1/2 years had fatter mothers than children who became relatively leaner. Relatively more children of the lower social class became fatter than children of the higher social class. However, parental fatness level and social class were not in a simple additive way related to changes in skinfold thicknesses.

Age Factors↗
PubMed2003

Visual disturbances in a population-based survey of 6962 subjects: the German National Health Examination Survey 1998.

BACKGROUND: Available prevalence estimates of visual disturbances (excluding blindness) in Germany are based on data from highly selective populations. This report describes the prevalence of visual disturbances and potential determinants based on the German National Health Examination Survey from 1998. METHODS: A population-based cross-sectional study of the non-institutionalized population in unified Germany. People aged 18-79 years were eligible and were contacted by a multi-mode approach. The response proportion was 61%, resulting in a sample of 7124 subjects who participated in the study. Visual disturbances were assessed by a self-administered questionnaire. RESULTS: Prevalance rates are higher among women in unified as well as in East- and West Germany. The higher overall prevalence rates among women is mostly driven by higher prevalance rates at ages 18-49 years, especially for shortsightedness. The prevalence rates are higher in West Germany than East Germany. Visual disturbances are more prevalent among the middle and upper social class than the lower social class. Above the age group 40-44, the prevalence of visual disturbances considerably increases, to approximately 100% in the age group 55 years or older for both sexes and in both parts of Germany. CONCLUSIONS: Nearly 100% of German adults aged 50-79 years have some degree of visual disturbance that requires refractive correction. Prevalence rates of visual disturbances are higher among people from West Germany, people of higher social status and among women. Uncorrected visual disturbances are most prevalent in the age group 18-34 years and more often among males and subjects of lower social status.

Adolescent↗
PubMed1996

[Consumption, dietary habits and nutritional status of the Reus (IX) population. Evolution of food consumption, energy and nutrient intake and relationship with the socioeconomic and cultural level, 1983-1993].

BACKGROUND: Mediterranean diet (a greater intake of olive oil, cereals, legumes, fruits and vegetables), is related to a lower prevalence of some associated diseases. The aim of the study was to observe in a Spanish population the evolution of dietary intake, whether there could be changes in the contribution of different kinds of food in energy intake, and the importance of socioeconomic and cultural factors which could influence this phenomenon. METHODS: Dietary intake was evaluated using the 24 hours recall method in a representative sample (n = 941, age range = 10-69) of a Reus population (Spain). This longitudinal study consisted of 70% of the sample studied in 1983 using identical methodology. RESULTS: From 1983 to 1993, we observed a significant increment of lactic derivatives (50.0%), vegetables (12.5%) and fruit intake (10.6%), and a significant decrease in tubercles (-56%), eggs (-15.6%), sugars (-13.0%), milk (-9.2%), and cereal (-7.6%) intake. Meat, fish, and visible fat intake remained unchanged. The intake of the 9 groups of food was different for men and women along this time period. We observed an increment in animal sources to our diet, primarily because of an increment in lactic derivative intake and a decrease in tubercles intake. Differences observed in 1983 between social classes related to different kinds of nutrients had nearly disappeared in 1993. Medium and high social classes followed very similar diets. However, the group of population with lowest socioeconomic status had a lower intake of energy and nutrients. CONCLUSIONS: Our diet consisted of the main characteristics of the typical mediterranean diet, although we observed a decrease in cereal intake and an increase in food of animal origin. Differences observed in 1983 related to dietary habits and nutritional profile between medium and high social classes, disappeared in 1993. However, there exists a small group of people of low social class which had a lower intake of energy and other nutrients.

Adolescent↗
PubMed2002

Life and death of the people of London: a historical GIS of Charles Booth's inquiry.

Social reformer Charles Booth undertook a massive survey into the social and economic conditions of the people of London at the end of the 19th century. An important innovation of his Inquiry was the construction of large, detailed maps displaying social class of inner London on a street-by-street basis. These provide a detailed and vivid picture of the geography of poverty and affluence at this time. These maps have been digitised, georeferenced and linked to contemporary ward boundaries allowing Booth's measurement of social class to be matched to the measurement of social class in the 1991 census of population and standardised mortality ratios derived for all causes of death in the survey area between 1991 and 1995. The social class data were used to derive an index of relative poverty for both time periods and a comparison of the geographies of relative poverty and their relationship with contemporary mortality was made. Although the overall standard of living had increased, the geography of poverty at the end of the 19th century was very similar to that at the end of the 20th century. Moreover, the geography of all causes of death for people over the age of 65 was more strongly related to the geography of poverty in the late 19th century than contemporary patterns of poverty. This relationship was also true for mortality for specific diseases that are related to deprivation in early life. The paper concludes that the spatial patterns of poverty in inner London are extremely robust and a century of change has failed to disrupt it.

Cause of Death↗
PubMed2004

Teenage mother's predictions of their support levels before and actual support levels after having a child.

OBJECTIVES: To evaluate to what extent teenage mothers are able to predict their postnatal support networks in the antenatal period, and the extent to which support correlates with depressive symptomatology and social class. DESIGN: A prospective cohort study. SETTING: Teenage antenatal clinic. PARTICIPANTS: Teenage mothers (n=124) aged less than 18 years. INTERVENTION: Women were surveyed in the antenatal period and again 6 months postpartum about their anticipated and actual levels of support using the Maternal Social Support Index. The questionnaire covered key issues involved in discharge planning such as the availability of help with household tasks, emergency respite, and communication. Subjects also completed social class data and the Edinburgh Postnatal Depression Scale. MAIN OUTCOME MEASURE: Ability of pregnant teenagers to predict postnatal support and correlation of support with social class and depressive symptomatology. RESULTS: The key finding was that teenage mothers significantly overestimated their support networks in the antenatal period compared to the reality experienced 6 months postpartum (P=0.0001). Dissatisfaction was most marked in the communication and daily activity support subscales. The level of support at 6 months postpartum correlated significantly with the Edinburgh Postnatal Depression score (P=0.0001) and with social class (P=0.017). CONCLUSION: Services for teenage mothers that provide assistance with communication and daily support activities are required to help overcome the discrepancies between idealization and reality. Poor support correlates with depressive symptomatology and social class.

Adolescent↗
PubMed2001

Socioeconomic status and lung cancer risk in Canada.

BACKGROUND: Several epidemiological studies have found that lung cancer is inversely related to socioeconomic status (SES) and suggest it as a possible risk factor for lung cancer. This study examines SES and lung cancer risk in Canada. METHODS: Mailed questionnaires with telephone follow-up were used to obtain data on 3280 newly diagnosed, histologically confirmed lung cancer cases and 5073 population controls, between 1994 and 1997, in eight Canadian provinces. Measurement included information on SES, smoking habits, alcohol use, diet, residential and occupational histories and both residential and occupational exposure to environmental tobacco smoke (ETS). Odds ratios (OR) and 95% CI were derived from unconditional logistic regression analysis. RESULTS: Compared with high income adequacy, an increased risk was found among low income males and females, with adjusted OR of 1.7 (95% CI : 1.3-2.2) and 1.5 (95% CI : 1.1-2.0), respectively. Compared with < or = 8 years of education, the adjusted OR were 0.6 (95% CI : 0.5-0.7) and 0.6 (95% CI : 0.5-0.8) for > or = 14 years education among males and females, respectively. Lung cancer risk was significantly increased for males of some social classes. The population attributable risk for income adequacy, education and social class was 24%, 25% and 21% among males, respectively, and 14% and 19% for income adequacy and education among females, respectively, in this Canadian population. CONCLUSIONS: A statistically significant association between income adequacy, education social class and lung cancer risk was found.

Adult↗
PubMed2006

Counteracting stress through leisure coping: a prospective health study.

The purpose of this study was to examine stress-buffer or -counteracting effects of leisure coping, by taking into account several key axes of society (i.e., gender, social class, and age) that are essential to characterize the diverse nature of our society. A 1-year prospective survey of a representative sample (n = 938) from an urban Canadian city was conducted. In the total sample, long-term health protective benefits of leisure coping became evident when stress levels were higher than lower (i.e., support for buffer effects of leisure coping). However, a health-protective effect of leisure coping to counteract the impact of stress on health was found substantially stronger for people with lower social class than for those with higher social class. On the other hand, health-protective stress-buffer effects of leisure coping were evident regardless of people's gender and age. The findings underscore the importance of giving greater attention to the role of leisure as a means of coping with stress in health practices, particularly among marginalized groups such as individuals with lower social class.

Adaptation, Psychological↗
PubMedDate not supplied

ABO genes are differentially distributed in socio-economic groups in England.

No direct evidence is available concerning what average genetic differences, if any, characterize the segments of socially stratified human populations, although theoretical considerations suggest that genetic differentiation within such populations is to be expected. We have now analysed two large samples of data from blood donors in England to test whether the distributions of the ABO and Rhesus blood group phenotypes are random with respect to socio-economic groups as determined by occupational classification. We have found that in both native and migrant sections of the populations of two widely separated regions (south-west England and part of Yorkshire) and in both sexes, the A phenotype is highly significantly more, and the O phenotype significantly less, frequent than expected in social classes I and II, while the converse is seen in social classes III-V. An individual of the A phenotype has thus about 15% greater probability than chance would dictate of being placed in classes I and II. The distribution of the Rh+ and Rh- phenotypes does not differ significantly between classes. It seems unlikely that this nonrandom distribution of the ABO phenotypes among socio-economic groups results from sampling, historical or migrational effects and we conclude that the observed association is likely to result from pleiotropic effects of the ABO alleles (or genes closely linked to them) on attributes influencing occupational type, social mobility and social class.

ABO Blood-Group System↗
PubMed1998

Alcohol, methylxanthine-containing beverages, and colorectal cancer in Córdoba, Argentina.

The relationship between social class indicators, body mass index (BMI), selected life-style habits (alcohol, coffee, maté and tea drinking) and colorectal cancer was investigated in a case-control study conducted between 1993 and 1997 in Córdoba, Argentina, a relatively high mortality area of colorectal cancer. Cases were 190 patients below age 80 years with incident, histologically confirmed colorectal adenocarcinomas, and controls were 393 patients admitted to hospital for a wide spectrum of acute, non-neoplastic disorders. Higher social class, based on occupation of the head of the household, was significantly associated with colorectal cancer risk: the odds ratios (OR) and 95% confidence intervals (95% CI) were 1.9 (1.2-2.9) for intermediate and 2.0 (1.2-3.4) for the highest as compared to the lowest social class individuals. When compared with subjects whose BMI was < 25 kg/m2, the OR was 1.1 (0.7-1.6) for those with BMI 25 to 29 kg/m2, and 1.3 (0.7-2.3) for those > or = 30. In comparison with alcohol abstainers, the OR was 2.8 (1.6-5.1) for drinkers, and there was a significant trend in risk with dose. The association was observed with wine (the most common alcoholic beverage in Argentina), as well as for beer and spirits. The consumption of coffee, maté and tea was not significantly related to colorectal cancer, but the ORs were below unity (0.9 (0.7-1.3) for coffee, 0.9 (0.6-1.2) for maté and 0.8 (0.6-1.2) for tea drinkers). The relationship between social class, alcohol drinking and colorectal cancer were consistent across strata of sex and age. This study confirms that colorectal cancer has positive social class correlates. The association with alcohol drinking is apparently stronger than previously reported, and may be due to the role of chance and/or peculiar correlates of alcohol drinking in this Argentinean population.

Adult↗
PubMed1997

Social status, social context, and arterial blood pressure.

As social change and economic development have proceeded, the prevalence of chronic diseases, especially cardiovascular diseases, has increased in the developing world. In part this is due to the adoption of diets and other health behaviors characteristics of industrialized nations; in part it is a function of changing social and economic circumstances. In this paper, we describe the development and testing of a model designed to account for social and economic effects on cardiovascular disease risk. The model incorporates the fact that global economic processes have made a lifestyle characterized by the consumption of Euroamerican material goods and information a basis for the assignment of social status in local communities. But economic change at the local level is rarely sufficient to provide a foundation for individuals' status aspirations. Hence, many individuals attempt to maintain lifestyle inconsistent with their economic standing, a variable we term lifestyle incongruity. Here we described how this factor is associated with higher blood pressure in a variety of settings and also how the effects of lifestyle incongruity can be modified in local contexts by social class and social role processes. This latter process, contextual modification, is illustrated by data from American Samoa. In this example, the association of lifestyle incongruity with blood pressure is examined in 30 male household heads and 26 spouses. After an examination of Samoan ethnography focused attention on the importance of age and gender differences as defining social contexts of intracultural variation, the model was modified to assess interactions between age and gender as they affect the association of lifestyle incongruity and blood pressure. Lifestyle incongruity is strongly associated with higher systolic and diastolic blood pressure for the younger household heads, minimally associated with blood pressure for older household heads, and only slightly associated with blood pressure of their spouses. The regression coefficients for the lifestyle incongruity by age by sex interaction term was significant at P < or = 0.01 for both systolic and diastolic blood pressure. The consistency of these results with expectations based on the ethnographic record is emphasized in the interpretation. We feel that the lifestyle incongruity model represents and empirically successful attempt to link global political-economic processes, local social structure, and biological outcomes.

Adult↗