What is social class?

Social class is a general measure obtained by combining occupational groups roughly equivalent in terms of employment relations to form occupational classes in the UK; these can also be seen as an indirect indicator of education, income, standards of living, environment and working conditions. In 2001 the new classification, the National Statistics Socioeconomic Classification (NS-SEC) was introduced to overcome some of the drawbacks of the previously used Registrar General’s (RG) classification (for example, the RG did not include people who were unemployed nor deal adequately with women’s occupations). The NS-SEC is now being linked to mortality and morbidity data but as it has only been applied recently this spread relies on analyses based on the older RG classification. Other important categorizations which you may come across that use information on employment status and occupational data are socioeconomic group (SEG) and socioeconomic status (SES).

Social class and health

Over the last 100 years there have been great improvements in the health of the UK population (see pp. 40–41). However, inequalities between different sections of the population still exist; one form of increasing disparity that has received particular attention is social class inequality in health (Davey Smith et al., 2000). Death rates for the UK can be calculated for occupational classes by combining data collected on birth and death certificates with occupational data collected at the decennial census. Although reproductive and adult mortality rates for each social class have been decreasing over the last 100 years, there has, however, been an increase in the disparity in mortality rates between social classes I and II, and social classes III to V.

Figure 1 illustrates the most recently reported gradations in life expectancy at birth (see pp. 42–43) from social class I through to social class V (RG classification). Class differentials exist in each of the 14 major cause-of-death categories used in the International Classification of Diseases. When married women are classified according to their husband’s occupation, similar if smaller differentials also appear. Only one cause of death for men, malignant melanoma, and four for women, including breast cancer, show a reverse trend. In general, the evidence also shows that disparities in illness, and especially chronic illness, are at least as wide as disparities in death.