Abstract
Class differences in mortality rates are the most widely used measures of the social distribution of health. Though they have many shortcomings, they are the best data we have. The last comprehensive figures available for England and Wales centre on 1981 and show differences in age-specific death rates between classes I (professional occupations) and V (unskilled manual occupations), which, if applied throughout the lives of a cohort, would produce a difference of more than seven years in life expectancy at birth (OPCS 1978, p. 190). This amounts to a 10 per cent difference in life-expectancy — the equivalent to shortening the unskilled manual worker’s day from 24 to about 21 hours or lopping five weeks off every year. (Because of problems in classifying women by occupational class, I refer to male death rates throughout this paper. The differences between the sexes, while important in other contexts, do not affect the argument put forward here.)
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References
Berkman, L. F. and Syme, S. L. (1979) ‘Social networks, host resistance and mortality: a nine-year follow-up study of Alameda County residents’, American Journal of Epidemiology, 109, 186.
Black Report, (1980) Inequalities in Health, Report of a DHSS Working Party chaired by Sir Douglas Black (London: DHSS).
Brown, G. W. and Harris, T. (1978) Social origins of Depression, (London: Tavistock).
Fox, A. J. and Goldblatt, P. O., Longitudinal Study: Socio-demographic Mortality Differentials, OPCS Series LS No. 1 (London: HMSO).
Grossarth-Maticek, R., Siegrist, J. and Vetter, H. (1982) ‘Interpersonal repression as a predictor of cancer’, Social Science and Medicine, 16, 493–8.
Karasek, R., Baker, D. et al. (1981) ‘Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men’, American Journal of Public Health, 71(7), 694–705.
Leon, D. and Wilkinson, R. G. (1987) ‘Inequalities in prognosis: socioeconomic differences in cancer and heart disease survival’, in Inequalities in Health in Europe, ed. A. J. Fox, London, Gower. In Press.
Lynge, E. and Anderson, O. (1985) Mortality: A Comparison of Within-Country Differentials Based on Selected Occupational Groups, paper presented at European Science Foundation meeting, London, September.
McKeown, T. and Lowe, C. R. (1974) An Introduction to Social Medicine (Oxford: Blackwell).
Marmot, M. G. (1986) ‘Social inequalities in mortality — the social environment’, in Wilkinson, R. G. (ed.) 1986. New Earnings Survey (1970) Department of Employment (London: HMSO).
Palmore, E. (1969) ‘Predicting longevity’, Gerontologist, 9, 247.
Pamuk, E. R. (1985) ‘Social class inequality in mortality from 1921 to 1971 in England and Wales’, Population Studies, 39, 17–31.
Registrar General (1961) Decennial Supplement, Occupational Mortality Tables (London: HMSO).
Registrar General, (1978) Occupational Mortality 1970–2, OPCS Series DS No. 1 (London: HMSO).
Rodgers, G. B., ‘Income and inequality as determinants of mortality: an international cross-section analysis’, Population Studies, 33, 343–51.
Sawyer, M. (1976) Income Distribution in OECD Countries, OECD Economic Outlook, Occasional Studies.
Siegrist, J. (1984) ‘Threat to social status and cardiovascular risk’, Psychotherapy and Psychosomatics, 42, 90–6.
Townsend, P. (1982) ‘An alternative anti-poverty programme’, New Society, 62(1038), 22–3.
Wads worth, M. E. J. (1986) ‘Serious illness in childhood and its association with later life achievement’, in Wilkinson (ed.) 1986.
Wilkinson, R. G. (1983) ‘Approaches to research on socioeconomic factors contributing to social class differences in Health’, unpublished paper presented to Social Science Research Council Conference on Inequalities in Health, November.
Wilkinson, R. G. (1986a) ‘Socio-economic differences in mortality: interpreting the data in their size and trends’, in Class and Health: Research and Longitudinal Data, (ed.) R. G. Wilkinson (London: Tavistock).
Wilkinson, R. G. (1986b) ‘Income and mortality’, in Wilkinson (ed.) 1986.
World Bank (1983) World Tables, volume II.
Young, M. and Willmott, P. (1957) Family and Kinship in East London, (London: Routledge & Kegan Paul).
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© 1988 The Eugenics Society
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Wilkinson, R.G. (1988). Health, Inequality and Social Structure. In: Keynes, M., Coleman, D.A., Dimsdale, N.H. (eds) The Political Economy of Health and Welfare. Studies in Biology, Economy and Society. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-09644-2_11
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DOI: https://doi.org/10.1007/978-1-349-09644-2_11
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