Social class and cause of death

Area of Science:

• Public Health
• Social Epidemiology
• Mortality Studies

Background:

• Socioeconomic status (SES) is known to influence mortality, but detailed variations across specific causes of death require further investigation.
• Previous research indicates differing relationships between social class and mortality, necessitating a comprehensive analysis.

Purpose of the Study:

• To provide a detailed and extensive description of social class differences for a wide range of specific causes of death.
• To quantify the variation in mortality gradients across different social classes and specific diseases.

Main Methods:

• Utilized Swedish death records from 1991-2003, linked to 1990 household social class data.
• Employed Cox Regression to estimate relative death risks and excess mortality for men and women across eight social classes.
• Analyzed causes of death based on the European shortlist.

Main Results:

• A distinct mortality gradient was observed for most causes, with higher occupational classes showing lower risks and unskilled workers facing higher risks.
• Significant variation exists in the strength of social class associations; some causes like malignant melanoma and transport accidents showed no clear class differences.
• Mental and behavioural disorders, endocrine/metabolic diseases, and respiratory diseases exhibited steep mortality gradients for both sexes.
• Circulatory diseases and cancer contributed substantially to excess mortality, accounting for 15-20%.

Conclusions:

• The general pattern of lower mortality in higher social classes is robust, with few exceptions where higher classes face greater risks or no gradient exists.
• Despite the consistent pattern, considerable variation in the magnitude of social class differences was found for specific causes of death.