Class Relations and All-Cause Mortality: A Test of Wright's Social Class Scheme Using the Barcelona 2000 Health Interview Survey

Abstract

The aim of this study is to test the effects of neo-Marxian social class and potential mediators such as labor market position, work organization, material deprivation, and health behaviors on all-cause mortality. The authors use longitudinal data from the Barcelona 2000 Health Interview Survey (N = 7,526), with follow-up interviews through the municipal census in 2008 (95.97% response rate). Using data on relations of property, organizational power, and education, the study groups social classes according to Wright's scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled, and unskilled workers. Findings indicate that social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class men but not women. Workers (hazard ratio = 1.60; 95% confidence interval, 1.10–2.35) but also managers and small employers had a higher risk of death compared with capitalists. The extensive use of conventional gradient measures of social stratification has neglected sociological measures 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.

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References

Wright

E. O.

Class Counts: Comparative Studies in Class Analysis. Cambridge University Press, Cambridge, 2000.

Wright

E. O.

Classes. Verso, London, 1985.

Wright

E. O.

The comparative project on class structure and class consciousness: An overview. Acta Sociol. 32: 3–22, 1989.

Steinmetz

, and Wright

E. O.

The fall and rise of the petty bourgeoisie: Changing patterns of employment in the postwar United States. Am. J. Sociol. 94: 973–1018, 1989.

Western

, and Wright

E. O.

The permeability of class boundaries to intergenerational mobility among men in the United Sates, Canada, Norway and Sweden. Am. Sociol. Rev. 59: 606–629, 1994.

Wright

E. O.

The American class structure. Am. Sociol. Rev. 47: 709–726, 1982.

Muntaner

Social class, assets, organizational control and the prevalence of common groups of psychiatric disorders. Soc. Sci. Med. 47: 2043–2053, 1998.

Krieger

Williams

D. R.

, and Moss

N. E.

Measuring social class in US public health research: Concepts, methodologies, and guidelines. Annu. Rev. Public Health 18: 341–378, 1997.

Marmot

The status syndrome. How Social Standing Affects Our Health and Longevity. Owl Book, New York, 2004.

10.

Muntaner

Socioeconomic position and major mental disorders. Epidemiol. Rev. 26: 53–62, 2004.

11.

Lynch

J. W.

, and Kaplan

G. A.

Socioeconomic position. In Social Epidemiology, ed. Berkman

L. F.

and Kawachi

, pp. 76–94. Oxford University Press, New York, 2000.

12.

Muntaner

, and Lynch

Income inequality, social cohesion, and class relations: A critique of Wilkinson's neo-Durkheimian research program. Int. J Health Serv. 29: 59–81, 1999.

13.

Wohlfarth

Socioeconomic inequality and psychopathology: Are socio-economic status and social class interchangeable?

Soc. Sci. Med. 45: 399–410, 1997.

14.

Borrell

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. 58(10): 1869–1887, 2004.

15.

Muntaner

The associations of social class and social stratification with patterns of general and mental health in a Spanish population. Int. J. Epidemiol. 32: 950–958, 2003.

16.

Galobardes

Indicators of socioeconomic position (part 2). J. Epidemiol. Community Health 60: 95–101, 2006.

17.

Borrell

Baranda

, and Rodríguez

Manual de l'enquesta de salut de Barcelona 2000. Internet report. Institut Municipal de Salut Pública, Bacrcelona, 2002. www.aspb.cat/quefem/docs/manual_2000.pdf (accessed June 8, 2009).

18.

Stansfeld

S. A.

Head

, and Marmot

M. G.

Explaining social class differences in depression and well-being. Soc. Psychiatry Epidemiol. 33: 1–9, 1998.

19.

MacLeod

Psychological stress and cardiovascular disease: Empirical demonstration of bias in a prospective observational study of Scottish men. BMJ 324: 1247–1251, 2002.

20.

Arber

, and Khlat

Introduction to “Social and Economic Patterning of Women's Health in a Changing World.”

Soc. Sci. Med. 54: 643–647, 2002.

21.

Borrell

. Social inequalities in mortality in a retrospective cohort of civil servants in Barcelona. Int. J. Epidemiol. 32: 386–389, 2003.

22.

Chandola

Social inequalities in health by individual and household measures of social position in a cohort of healthy people. J. Epidemiol. Community Health 57: 56–62, 2003.

23.

Bartley

Sacker

, and Clarke

Employment status, employment conditions, and limiting illness: Prospective evidence from the British household panel survey 1991–2001. J. Epidemiol. Community Health 58: 501–506, 2004.

24.

Wiggins

R. D.

Social position and minor psychiatric morbidity over time in the British Household Panel Survey 1991–1998. J. Epidemiol. Community Health 58: 779–787, 2004; erratum, 58:1055, 2004.

25.

MacKinnon

D. P.

The intermediate endpoint effect in logistic and probit regression. Clin. Trials. 4: 499–513, 2007.

26.

Petersen

M. L.

Sinisi

S. E.

, and van der Laan

M. J.

Estimation of direct causal effects. Epidemiology 17: 276–284, 2006.

27.

Grusky

D. B. V.

, and Sorensen

J. B.

Can class analysis be salvaged?

Am. J. Sociol. 103: 1187–1234, 1998.

28.

Johnson

Sorlie

, and Backlund

The impact of specific occupations on mortality in the US National Longitudinal Mortality Study. Demography 36: 355–367, 1999.

29.

Marshall

Social Class in Modern Britain. Hutchinson, London, 1988.

30.

MacLeod

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. 61: 1916–1929, 2005.