Social class and mortality risk

Abstract: Persons from lower social classes have a smaller chance to live a long and healthy life than persons from higher social classes. Larger relative mortality risks in lower social classes are not due simply to accidents, alcohol related mortality, or suicides. In fact, mortality differences between social classes are not caused by any specific set of diseases, but rather are found for all major causes of death. Causes behind class differences in illness and mortality are therefore likely to be complex, including for instance childhood conditions, health care, economic deprivation, housing, working conditions, and psychological stress from different kinds of deprivations.In this thesis some of the mechanisms behind, and manifestations of, class differences in mortality are explored. The data is based on a random sample of the Swedish population, aged between 23 and 75 years when originally interviewed in 1968. Different aspects of class differences in mortality are studied over a 29-year follow-up period, from 1968 to 1996. The lower social classes are more likely than the upper classes to get different illnesses. This is, for instance, valid for heart problems. The results in this thesis show that lower social classes have a more elevated mortality risk than do upper classes when having heart problems. This suggests that the inequalities in society not only make the lower social classes more susceptible to disease, but also affect the mortality risks linked to certain diseases.Results also show that childhood conditions are important for social class differences in mortality among adults - class differences are smaller among persons with good childhood conditions and larger among persons with poorer childhood conditions.People do not randomly end up in a certain social class. Several factors influence class position, for instance childhood conditions. The results of this thesis show that if persons were randomly distributed into social classes, class differences in mortality would be much larger than the differences normally observed. This means that the true effect of social class alone is much larger than the observed differences in most studies. The discrepancy between observed and true class differences in mortality seems to be explained by the way people are distributed into social classes early in their work careers.