Measuring inequalities in health: an analysis of mortality patterns using two social classifications

Abstract

The paper investigates relationship between mortahty and social class as measured by the Erikson-Goldthorpe schema, a validated measure of employment conditions, and compares this with differentials found using the Registrar General's social classes. Two cohorts of men aged 15/16-64 were drawn from the OPCS Longitudinal Study for 1971 and 1981. Mortality differences between social classes were estimated using deaths occurring between 1976 and 1980 in the first cohort and 1986 and 1989 in the second. The two classification were formally compared by means of the Relative Index of Dissimilarity and a likelihood-based statistic. Similar mortality differentials were found using both classifications in the two time periods. The Erikson-Goldthorpe schema showed a clear pattem of higher mortality in those groups without a career structure and with lower discretion over their work. The paper concludes that inequalities in health are seen when a validated social class schema based on employment conditions is used. The use of validated measures will make it possible for health differences to be more clearly interpreted in policy terms.

Mortality: Persistent social class mortality differences in New Zealand men aged 15–64: an analysis of mortality during 1995–97

“…30 Despite this, we found a stronger social class mortality gradient for the most recent time period, a result that is consistent with the international literature demonstrating that different scales of occupational class generate quite similar health disparities. 31 In fact, recent analyses by Blakely (personal communication) found very similar social class gradients when the Elley-Irving scale and the NZSEI scale (albeit using a different cutoff between classes 1 and 2) were both applied to the same dataset of mortality in males aged 45-64 years in 1991 for which the Census data were available for both the NZSCO-68 and NZSCO-90 codes. Thus, it seems unlikely that the increase in social class gradient over time reported here is due to the change in social class scale.…”

Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies Commentary: Unequal inequalities across Europe

“…A common occupational class scheme, the EGP (Erikson-Goldthorpe-Portocarero) scheme, was applied to as many countries as possible 10. This scheme was developed to facilitate international comparisons of social stratification and mobility and is therefore particularly suitable for this study.…”

Socioeconomic Inequalities in Stroke Mortality Among Middle-Aged Men

“…36,37 This scheme was developed to facilitate international comparisons of social mobility and is particularly suited for our purposes. Where possible, social class conversion algorithms were applied to individual-level data on the following aspects of the jobs that men perform: occupational title (by 3-digit code), employment status (self-employed or not), and supervisory status (eg, number of subordinates).…”