Social inequalities in male mortality amenable to medical intervention in British Columbia

The objective of this study is to examine the rates of mortality among different social classes and socioeconomic groups of British Columbian males from causes of death amenable to medical intervention. We examined the rates of avoidable mortality from the causes of death published by Charlton, excluding causes of death restricted to women as well as perinatal deaths. For the purposes of our study, we determined a population at risk using 20% samples of occupational data for men from the 1981, 1986 and 1991 censuses conducted by Statistics Canada. For the analysis of mortality by social class, individuals were divided into five social class levels based on occupation using an adaptation of the UK Registrar General's Social Class Scale. In addition, three levels of socioeconomic analysis were performed using the Blishen Index classification system. Once individuals were assigned to a social class in each classification system, the death rates from each amenable cause was calculated and standardized to the total population. For almost every cause of death examined, the rate of mortality was higher in individuals of lower social and socioeconomic classes than in individuals of the upper social and socioeconomic classes. These results were consistent regardless of the social class component, education, occupation, or income was being measured. The mortality gradient was most notable in deaths due to hypertensive heart disease, tuberculosis, asthma and pneumonia and bronchitis. Due to the fact that these causes of death were observed to be consistently higher in the lower social classes, we feel that specific measures aimed at improving survival from these conditions in lower social classes could help to amend the social class disparity.