The concept of status incongruence revisited

Abstract

The purpose of this study was to analyse the relationships between status incongruency and mortality. From the concept of status incongruence two incongruent groups were defined, those with high education and low social position (socially downward drifters) and those with low education and high social position (socially upstarters).

A cohort of middle-aged men (n = 855), all bora in 1913 and living in the city of Gothenburg, Sweden were followed during a period of 22 years. The socially downward drifters had a significantly increased risk for: non-cause specific (overall) mortality, more potential years of life lost and mortality caused by coronary heart disease. These differences were still evident after taking other risk factors into account. The socially upstarters had, on the other hand, lower mortality risks and win years. Imbalance between educational level and attained social position appears to affect survival in a long term follow-up.

Keywords

social epidemiology population study social class education risk factors mortality cardiovascular diseases

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References

Marmot M , Kogevinas M , Elston MA. Social-economic status and disease . Ann Rep Public Hlth 1987; 8: 111–35.

Lenski G. Status crystallization, a non-vertical dimension of social status . Am Sociol Rev 1954; 19: 405–13.

Lenski G. Social participation and status crystallization . Am Sociol Rev 1956; 21: 458–64.

Blalock H. Status inconsistency, social mobility, status interaction and structural effects . Am Sociol Rev 1967; 32: 790–801.

Horan P , Gray BH. Status inconsistency, mobility and CHD, a re-evaluation . J Hlth Soc Behav 1974; 15: 300–10.

Shekele R. Status inconsistency, mobility and CHD, a reply to Horan and Gray . J Hlth Soc Behav 1976; 1: 83–7.

Vernon S , Buffler PA. The status of status inconsistency . Epidemiol Rev 1988; 10: 65–86.

Kasl S , Cobb S. The intrafamilial transmission of rhematoid arthritis. VI. Association of rheumatoid arthritis with several types of status inconsistency . J Chron Dis 1969; 22: 259–78.

Jackson E. Status inconsistency and symptoms of stress . Am Sociol Rev 1962; 27: 469–80.

10.

Meile R , Haese PN. Social status, status incongruence and symptoms of stress . J Hlth Soc Behav 1969; 10: 237–44.

11.

Shekele R , Ostfeld AM , Paul O. Social status and incidence of coronary heart disease . J Chron Dis 1969; 22: 381–94.

12.

Szklo M , Tonascia J , Gordis L. Psychosocial factors and the risk of myocardial infarctions in white woman . Am J Epidemiol 1976; 103: 312–20.

13.

Haynes S , Eaker ED , Feinleib M. Spouse behavior and coronary heart disease in men: prospective results from the Framingham Heart Study. I. Concordance of risk factors and the relationship of psychosocial status to coronary incidence . Am J Epidemiol 1983; 118: 1–22.

14.

Suarez L , Barrett-Connor E.

Is an educated wife hazardous to your health?

Am J Epidemiol 1984; 119: 244–9.

15.

Medalie J , Snyder M , Groen JJ, et al. Angina pectoris among 10,000 men: 5 year incidence and univariate analysis . Am J Med 1973; 55: 583–94.

16.

Reed D , McGee D , Katsuhiko Y. Psychosocial processes and general susceptibility to chronic disease . Am J Epidemiol 1984; 119: 356–70.

17.

Lehman E , Schulman J , Hinkle LE. Coronary deaths and organizational mobility . Arch Environ Hlth 1967; 15: 455–61.

18.

Wan T. Status stress and morbidity, a sociological investigation of selected categories of work-limiting chronic conditions . J Chron Dis 1971; 24: 453–68.

19.

Wardell W , Bahnson CB. Behavioral variables and myocardial infarction in the Southeastern Connecticut Health Study . J Chron Dis 1973; 26: 447–61.

20.

Tibblin G. A population study of 50-year old men. An analysis of the non-participation groups . Acta Med Scand 1965; 178: 453–9.

21.

Tibblin G. High Blood pressure in man aged 50 — a population study of men born in 1913 (dissertation) . Acta Med Scand 1967; suppl. 470 .

22.

Svärdsudd K. High blood pressure. A longitudinal population study of men born in 1913, with special reference to development and consequences for health (dissertation) . Gothenburg University, 1978.

23.

Faresjö T. Social stratification and ill-health, in the Study of Men Born in 1913 (dissertation). Linkoping Stud Arts Sci, no 37 . Linkoping University, 1989.

24.

Cramer K , Isaksson B. An evaluation of the Theorell method for the determination of total serum cholesterol . Scand J Clin Lab Invest 1959; 11: 213 .

25.

Bradley J. Distribution-free statistical tests. London: Prentice-Hall, 1968.