Research Findings: Social class: Effect of people’s material circumstances on health Summary papers

 
Can health inequalities in disability in older adults be explained by perceptions of financial hardship and living standards?

Reduction of health inequalities is a key public health priority for government and understanding the underlying causes is vital if population based interventions are to be effective.  This project examined the roles of perceived financial hardship and reported standards of living over four decades of adult life were associated with observed health inequalities in older adults with disability.  We found that having poorer living standards (i.e. lack of ownership of material possessions such as a television and washing machine, for example) in earlier decades of life was an independent risk factor for disability in later life.  However, we found no link between perceived financial hardship and disability.

Adamson, J., K. Hunt, et al. (2006). "The psychosocial versus material hypothesis to explain observed inequality in disability among older adults: data from the West of Scotland Twenty-07 study." Journal of Epidemiology and Community Health 60: 974-980.
pubmed    open access

 


Is early life car ownership a good indicator of socioeconomic position?I

It has consistently been shown in the UK that those living in households with access to a car have lower death rates than those without car access.  Car ownership is often used as a good marker of material living standards or socioeconomic status when measures of income or occupation are unavailable.  However, is early life car ownership a good indicator of socioeconomic position and hence health outcomes? 

We asked two of the Twenty-07 Study cohorts born around 1932 and 1952 how old they were when they or their household first owned a car, and analysed the response by social class.  We found that car ownership was comparatively rare in the 1932 cohort but much more prevalent among the lower classes in the 1952 cohort.  Car ownership was likely to have been a stronger indicator of family advantage in childhood among the older 1932 cohort than with the younger cohort.  We suggest that using household car access in childhood or youth as a measure of socioeconomic position or access to material resources should be done with caution, as the significance of the measure may well vary by age cohort.  Likewise, other measures of social class such as house-ownership, education, etc. should take into account the historic context of the survey data being used and used with discretion.

Ellaway, A., S. Macintyre, et al. (2003). "The historical specificity of early life car ownership as an indicator of socio-economic position." Journal of Epidemiology and Community Health 57: 277-278.



Do home ownership and car access predict health because they are markers of income or self esteem?

People in rented homes, and those households without a car or access to one, have poorer health and higher death rates that those in owner-occupied or households with a car.  It has often been suggested that this is just because home and car ownership are indicators of income or psychological self worth/self esteem. 

This project examined what effects controlling for income or self esteem had on the link between health and home ownership or car access among all three cohorts from the Twenty-07 Study. 

We found that home ownership and car access were still related to a range of health measures after controlling for income and self esteem.  This suggested the need to examine further the health promoting or damaging effects of home ownership and car access.

Macintyre, S., A. Ellaway, et al. (1998). "Do housing tenure and car access predict health because they are simply markers of income or self esteem? A Scottish study." Journal of Epidemiology and Community Health 52: 657-664.
pubmed    open access