Capitalists,managers,professionals and mortality: Findings from the Barcelona Social Class and All Cause Mortality Longitudinal Study

Abstract

Aims: To examine the effects of Neo-Marxian social class (i.e. measured as relations of control over productive assets) and potential mediators such as labour-market position, work organization, material deprivation and health behaviours upon mortality in Barcelona, Spain. Methods: Longitudinal data from the Barcelona 2000 Health Interview Survey (n = 7526) with follow-up interviews through the municipal census in 2008 (95.97% response rate) were used. Using data on relations of property, organizational power, and education, social classes were grouped according to Wright’s scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled and unskilled workers. Results: Social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class positions for men but not for women. Workers (hazard ratio 1.60, 95% confidence interval 1.10—2.35), managers and small employers had a higher risk of death than capitalists. Conclusions: The extensive use of conventional gradient measures of social stratification has neglected sociological measurements of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the ‘‘contradictory class location hypothesis’’, additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers.

Keywords

Epidemiological methods follow-up mortality social class

Get full access to this article

View all access options for this article.

References

Wright EO Class counts: comparative studies in class analysis. Cambridge : Cambridge University Press; 2000 .

Bartley M. , Marmot M. Social class and power relations at the workplace . Occup Med State of the Art Rev 2000;15:73-8.

Muntaner C. , Parsons P. Income, social stratification, class, and private health insurance: a study of the Baltimore metropolitan area. Int J Health Services 1996;26:655-71.

Borrell C. , Muntaner C. , Benach J. , Artazcoz L.

Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?

Soc Sci Med 2004; 58:1869-87.

Muntaner C. , Eaton W. , Diala C. , Kessler R. , Sorlie P. Social class, assets, organizational control and the prevalence of common groups of psychiatric disorders. Soc Sci Med 1998;47:2043-53.

Krieger N. , Williams DR , Moss NE Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 1997;18:341-78.

Marmot M. The status syndrome. how social standing affects our health and longevity . New York: Owl Books; 2004.

Muntaner C. , Eaton WW , Miech R. , O’Campo P. Socioeconomic position and major mental disorders . Epidemiol Rev 2004;26:53-62.

Lynch JW , Kaplan GA Socioeconomic position. In: Berkman LF , Kawachi I , editors. Social epidemiology. New York, NY: Oxford University Press; 2000. pp. 76-94.

10.

Muntaner C. , Lynch J. Income inequality, social cohesion, and class relations: a critique of Wilkinson’s neo-Durkheimian research program . Int J Health Services 1999;29:59-81.

11.

Wohlfarth T.

Socioeconomic inequality and psychopathology: are socioeconomic status and social class interchangeable?

Soc Sci Med 1997;45:399-410.

12.

Muntaner C. , Borrell C. , Benach J. , Pasarín MI , Fernández E. The associations of social class and social stratification with patterns of general and mental health in a Spanish population. Int J Epidemiol 2003;32:950-8.

13.

Galobardes B. , Shaw M. , Lawlor DA , Lynch JW , Davey Smith G. Indicators of socioeconomic position (part 2). J Epidemiol Community Health 2006;60:95-101.

14.

Galobardes B. , Shaw M. , Lawlor DA , Lynch JW , Davey Smith G. Indicators of socioeconomic position (part 1). J Epidemiol Community Health 2006;60:7-12.

15.

Wohlfarth T. , van den Brink W. Social class and substance use disorders: the value of social class as distinct from socioeconomic status . Soc Sci Med 1998;47:51-8.

16.

Stansfeld SA , Head J. , Marmot MG Explaining social class differences in depression and well-being. Soc Psychiatry Epidemiol 1998 ;33:1-9.

17.

Macleod J. , Davey Smith G. , Heslop P. , Metcalfe C. , Carroll D. , Hart C. Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men. BMJ 2002 ;324:1247-51.

18.

Borrell C. , Baranda L. , Rodríguez M. Manual de l’enquesta de salut de Barcelona 2000. Barcelona: Institut Municipal de Salut Pública ; 2002. Available at: http://www.aspb.cat/quefem/docs/manual_2000.pdf (accessed 8 June 2009).

19.

Arber S. , Khlat M. Introduction to ‘‘social and economic patterning of women’s health in a changing world’’. Soc Sci Med 2002;54:643-7.

20.

Borrell C. , Cortes I. , Artazcoz L. , Molinero E. , Moncada S. Social inequalities in mortality in a retrospective cohort of civil servants in Barcelona. Int J Epidemiol 2003;32:386-9.

21.

Chandola T. , Bartley M. , Wiggins R. , Schofield P. Social inequalities in health by individual and household measures of social position in a cohort of healthy people. J Epidemiol Community Health 2003;57:56-62.

22.

Bartley M. , Sacker A. , Clarke P. Employment status, employment conditions, and limiting illness: prospective evidence from the British household panel survey 1991-2001. J Epidemiol Community Health 2004;58:501-6.

23.

Wiggins RD , Schofield P. , Sacker A. , Head J. , Bartley M. Social position and minor psychiatric morbidity over time in the British Household Panel Survey 1991-1998. J Epidemiol Community Health 2004;58:779-87. Erratum: J Epidemiol Community Health 2004;58:1055.

24.

Marshall G. , Rose D. , Newby H. , Vogler C. Social class in modern Britain. London: Hutchinson; 1988.

25.

MacKinnon DP , Lockwood CM , Brown CH , Wang W. , Hoffman JM The intermediate endpoint effect in logistic and probit regression. Clin Trials 2007;4:499-513.

26.

Petersen ML , Sinisi SE , van der Laan MJ Estimation of direct causal effects. Epidemiology 2006 ;17:276-84.

27.

Grusky DBV , Sorensen JB

Can class analysis be salvaged?

Am J Sociol 1998;103:1187-234.

28.

Johnson N. , Sorlie P. , Backlund E. The impact of specific occupations on mortality in the US National Longitudinal Mortality Study. Demography 1999;36:355-67.

29.

Macleod J. , Davey Smith G. , Metcalfe C. , Hart C. Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men. Soc Sci Med 2005;61:1916-29.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB