Theory driven analysis of social class and health outcomes using UK nationally representative longitudinal data
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(2020) 19:193
RESEARCH
Open Access
Theory driven analysis of social class and health outcomes using UK nationally representative longitudinal data Welcome Wami1,2, Gerry McCartney3, Mel Bartley4, Duncan Buchanan5, Ruth Dundas1, Srinivasa Vittal Katikireddi1, Rich Mitchell1 and David Walsh6*
Abstract Background: Social class is frequently used as a means of ranking the population to expose inequalities in health, but less often as a means of understanding the social processes of causation. We explored how effectively different social class mechanisms could be measured by longitudinal cohort data and whether those measures were able to explain health outcomes. Methods: Using a theoretically informed approach, we sought to map variables within the National Child Development Study (NCDS) to five different social class mechanisms: social background and early life circumstances; habitus and distinction; exploitation and domination; location within market relations; and power relations. Associations between the SF-36 physical, emotional and general health outcomes at age 50 years and the social class measures within NCDS were then assessed through separate multiple linear regression models. R2 values were used to quantify the proportion of variance in outcomes explained by the independent variables. Results: We were able to map the NCDS variables to the each of the social class mechanisms except ‘Power relations’. However, the success of the mapping varied across mechanisms. Furthermore, although relevant associations between exposures and outcomes were observed, the mapped NCDS variables explained little of the variation in health outcomes: for example, for physical functioning, the R2 values ranged from 0.04 to 0.10 across the four mechanisms we could map. Conclusions: This study has demonstrated both the potential and the limitations of available cohort studies in measuring aspects of social class theory. The relatively small amount of variation explained in the outcome variables in this study suggests that these are imperfect measures of the different social class mechanisms. However, the study lays an important foundation for further research to understand the complex interactions, at various life stages, between different aspects of social class and subsequent health outcomes. Keywords: Health inequalities, Self-rated health, SF-36, Social class theory, Socio-economic position
* Correspondence: [email protected] 6 Glasgow Centre for Population Health, Olympia Building, Bridgeton Cross, Glasgow G40 2QH, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this art
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