Social Class

Keelie Hay

Social Class

Many sociologists have proved that illness and ill health is related to social class. This is defining between the rich and the poor. However Social Class is very difficult to measure because it is difficult to define Social Class. Social class is difficult to measure because as some class registers don’t look at women’s occupation The type of worker today sees work as a means to an end, meaning people only do their job to earn money. Nowadays workers aren’t as hostile towards capitalism, now we see capitalism as raising living standards. Now workers identify themselves through their family and standard of living, whereas before it was through their work. This was shown from researcher (Davey Smith et al, 1990). When he discovered that routine clerical workers are much more likely to die younger than other workers are. Smith compared the lowest and higher classes, found people in the lower classes were three times more likely to die before the age of 65 than those in the higher classes.

The underclass, to some researchers such as (Sanders 1990) thinks that the excuse for the underclass is that they are work shy. Another researcher (Jordan, 1992) had a different criticism to the one from Sanders he suggests that not everyone who is poor is work shy this is related to illness because most people in the under class cant afford to go to the doctors and get treatment for their illnesses. Researcher (Marshal et al 1988) suggests that workers are still aware of class inequalities. He said that the working class is more fragmented but still is distinctive, for example divisions within the working class. An example of this is where there are two people working and are doing the same job but because one is 18 and one is 21 they are getting paid differently. These divisions exist because of gender and ethnicity. This applies to women and men who do the same job, but the women is probably getting less pay and has less job security than the men.

In 1999 Mary Shaw looked into whether or not social class was related to ill health, they compared the health records of people with very bad health records and of those with very good health records. The gap found from their research surprised them. It showed that in worse health areas

Children under 1 years old were twice likely to die, there are ten times more women under 65 who are permanently sick and disabled, adults have a 70 per cent greater chance of dying before 65 and adults are three times as likely to state that they have a ...

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These differences reflect the differences in income and the levels of deprivation.

Mortality rates, which are the measure of deaths per thousand population, over the last twenty years, death rates have fallen for both men and women, in all social classes. Although those people in the higher social classes have actually fallen faster, this means that the difference in rates between those in higher and those in the lower social classes, the gap has grown. In the early 1970’s the death rate among men, which were of the working age was almost twice as high for those in class V (unskilled) as for those in class I (professional). It then reached almost three times as high by the 1990’s. The women in social class I can expect to live six years longer than those in social class V whilst the men in social class I can expect to live for almost nine years longer than men from social class V.

The Black report published in the 1980s showed that there was a pattern to the wealth and health experienced by the different social classes. Based on occupation the report showed health inequality, and suggested that professionals do far better than managers do, and managers do far better than skilled workers and so on down the line. Reported illness is at the top of the iceberg. However there are also theories that try explaining the results of the Black report, suggesting that the system of health care is not such an important factor as other life circumstances that affect the health of different classes.

The artefact theory suggests that the use of surveys for statistics is inaccurate because it fails to take into consideration the clinical iceberg where it is unknown how many people suffer illness, as they don’t always report it. Also most health care happens in the home usually women treating symptoms by self-care, in the case of postal surveys not everyone will respond and women often fill in forms for other family members. It is also unreliable because the figures relate to males of working age and not females and older and younger people and the statistics change all the time. However another study known as the Whitehall study gave evidence that there is a “real” relationship between social class and health outcome.

Marsh, 2000 showed that when different grades of workers was compared, those in the lowest grade had 3.6 times greater risk of dying from heart disease than those in the highest grade.

The other explanation considered by the Black report accepted the relationship between social class and health, this argues that people do not suffer ill health because of social class, but that people are in low Social Class because of their poor health. For example people who have ‘chronic illnesses’. Because people who have poor health, they have to have more time off work or school and so can not make up social scale.

The cultural or individualist theory suggests that there is something about the culture of the lower classes that is unhealthy; they tend to smoke and drink more and it is attitude not income at fault so individuals are to blame for not looking after their health.

Harvey 1993 suggested the individualist theory which argues that the lower social classes have poorer health because, through choice or ignorance, they adopt unhealthy behaviour.

The materialistic theory believes that conditions such as poverty or homelessness are a direct cause of mortality.

“Despite the existence in Britain of a National Health Service there are still vast social divisions of health outcomes, Social class divisions in mortality and morbidity are probably the result of material factors.”(Marsh 2000)

The health and illness that affect the social classes is often influenced by their environment for instance the child mortality rate of the lower classes can be caused by living in poverty, damp housing, low income, inadequate diet, through unemployment. All the issues which contribute to stress and depression of the lower class is caught in a circle where each problem contributes to another and so lifestyles tend to stay the same. This diminishes hope and limits choices causing a threat to health. The lower classes also have the worst facilities of health care. Doctors and specialists who are able to choose the areas they work will more often choose middle-class areas where they will have the advantage of better staff and equipment. Hillary Graham’s work on women and smoking suggested that smoking might help women in poverty to cope because it is a method of relaxation, her way of having a break from the main interaction with small children. This is a criticism of social class.

Our ideas in society tend to construct gender differences in health problems. There appears to be some evidence that men take more risks than women such as dangerous sports and violent activities and hazardous occupations. Also women tend to consult doctors more often but yet statistics suggest women have more ill health, but this could be because women in their socially produced gender roles are seen as more acceptable to show weakness and seek medical help. Women’s lives are more often medicalised than men, in childbirth, reproduction and mental health women are more likely to be given prescriptions for anti-depressants or tranquillisers, men however are more likely to have alcohol related problems, a more socially acceptable response to stress than it is for women. Peter Sedgwick found that:

“About 10% of all GPs prescriptions and 20% of annual expenditure goes on tranquillisers, anti- depressants or hypnotic drugs, mainly for women”