Causal and Selective Factors in Sickness

Perrott, J.W.; Sydenstricker, Edgar

doi:10.1086/216985

Cited by 7 publications

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“…The present article considers one of the most controversial hypotheses, known in the epidemiological literature as the health selection hypothesis or drift hypothesis (Stern, 1983;West, 1991;Blane, Davey Smith, & Bartley, 1993), which was first advanced in the 1930s (Perrot & Collins, 1935;Lawrence, 1948;Illsley, 1955;Morris & Heady, 1955;Perrot & Sydenstriker, 1955;Meadows, 1961;Goldberg & Morrison, 1963) and which argues that health status has a causal effect on individuals' chances of (inter-and intragenerational) social mobility. In other words, the selection hypothesis sees health as one of the factors responsible for ''barriers to social mobility'' (Giddens, 1973;Goldthorpe, 1980).…”

Section: Introductionmentioning

confidence: 99%

Social mobility and health in the Turin longitudinal study

Costa

Demaria

2004

Social Science & Medicine

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One of the most controversial explanations of class inequalities in health is the health selection hypothesis or drift hypothesis which suggests there is a casual link between the health status of individuals and their chances of social mobility, both inter-and intra-generational. This study tests this hypothesis, and tries to answer three related questions: (a) to what extent does health status influence the chances of intra-generational mobility of individuals? (b) what is the impact on health inequalities of the various kinds of social mobility (both mobility in the labour market and exit from employment)-do they increase or reduce inequalities? (c) to what extent does health-related intra-generational social mobility contribute to the production of health inequalities?The data analysed in this paper were drawn from the records of the Turin Longitudinal Study, which was set up to monitor health inequality of the Turin population by combining census data, population registry records and medical records. Occupational mobility was observed during the decade 1981-1991. To evaluate the impact of the various processes of social mobility on health inequalities, mortality was observed over the period [1991][1992][1993][1994][1995][1996][1997][1998][1999]. The study population consists of men and women aged 25-49 at the beginning of mortality follow-up (1991), and registered as resident in Turin at both the 1981 and the 1991 censuses (N ¼ 127;384). Health status was determined by observing hospital admission. For the purpose of the study healthy individuals were those with no hospital admissions during the period 1984-1986, while those admitted were classed as unhealthy. Social mobility in the labour market was measured via an interval data index of upward and downward movements on a scale of social desirability of occupations, designed for the Italian labour force via an empirical study carried out by de Lillo and Schizzerotto (La valutazione sociale delle occupazioni. Una scala di stratificazione occupazionale per l'Italia contemporanea, Il Mulino, Bologna, 1985). Movement out of the labour market was described by a discrete variable with four conditions: employed, unemployed, early retired and women returning from work to the housewife status. The relationship between health status and occupational mobility was analysed via analysis of variance and multinomial logistic regression. Health inequalities were measured by the ratio of standardised mortality rates in the unskilled working class and the upper middle class.The study found a weak relationship between health status and occupational mobility chances. Decidedly stronger was the impact on occupational mobility of gender, education and ''ethnicity'' (being born in the South of Italy). The relationship between occupational mobility and health takes two different forms. Occupational mobility in the labour market decreases health inequalities; occupational mobility out of the labour market (early retirement, unemployment, housewife return) widens them. Th...

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Section: Introductionmentioning

confidence: 99%

Social mobility and health in the Turin longitudinal study

Costa

Demaria

2004

Social Science & Medicine

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“…Sydenstricker was very much interested in the direction of causality. In the article "Causal and selective factors in sickness" Perrott and Sydenstricker (1935) offered a detailed discussion of this and explored whether the high rates of illness in families with the greatest income losses are caused by the income changes, or whether there is a selection process, in the sense that households with pre-existing illness were less able to remain employed as the economy contracted. They argued that focussing on the impacts on the health of both adults and children helps identify the causal effects of family income loss due to unemployment.…”

Section: Evaluation Of Public Health Interventionsmentioning

confidence: 99%

Edgar Sydenstricker, a pioneer of health economics

Clarke¹,

Erreygers²

2022

The European Journal of the History of Economic Thought

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The economist Edgar Sydenstricker, who spent most of his working life at the United States Public Health Service and at the Milbank Memorial Fund, examined a wide range of health economics issues. He contributed to the debate around the cause of the disease pellagra. This research was followed by many studies quantifying income-related health inequalities. Sydenstricker was heavily involved in the use of surveys to collect information and he was instrumental in the development of the first US National Health Survey. Other contributions include extending health insurance in the United States and methods of evaluating public health programs. KEYWORDS Socioeconomic inequality of health; history of health economics; early 20th century; Edgar Sydenstricker JEL CLASSIFICATION CODES B31; I14; I18

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Why Does Influenza Hit the Poor More Than the Rich? A 1931 Social Epidemiology Article That Broke New Ground in the History of Confounding, Mediation, and Interaction

Morabia¹

2021

American Journal of Epidemiology

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In 1931 Edgar Sydenstricker, statistician of the United States Public Health Service, challenged the common belief that the 1918 Flu had affected “the rich and the poor alike." Using data from 112,317 participants of a US national survey on the 1918 Flu he observed that, on the contrary, both the morbidity and mortality from the flu had been higher among the poor than among the rich. To explain these differences Sydenstricker stratified the analyses by two measures of affluence collected in the survey: “economic status” (from “very poor” to “well-to-do”) and household crowding (ie, number of people per household room). Economic status was associated with influenza attack rates within categories of crowding, but not the opposite, suggesting that other characteristics of poverty than “household congestion” were the culprit of the poor’s higher influenza burden. Risk of influenza in infants and older adults was greater for the poor or very poor. Sydenstricker used a stratification approach to assess confounding, mediation, and interaction before the concepts were formally named. Sydenstricker re-analyzed an already 12-year old dataset in the context of the Great Depression to build the evidence base relating poverty to ill health.

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Causal and Selective Factors in Sickness

Cited by 7 publications

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Social mobility and health in the Turin longitudinal study

Social mobility and health in the Turin longitudinal study

Edgar Sydenstricker, a pioneer of health economics

Why Does Influenza Hit the Poor More Than the Rich? A 1931 Social Epidemiology Article That Broke New Ground in the History of Confounding, Mediation, and Interaction

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