© 1998 Oxford University Press
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Morbidity differences by occupational class among men in seven European countries: an application of the Erikson-Goldthorpe social class scheme
aDepartment of Public Health, Erasmus University PO Box 1738, 3000 DR Rotterdam, The Netherlands
bDepartment of Health Policy and Management, Erasmus University The Netherlands
cStatistics Netherlands Heerlen, The Netherlands
dBremer Institut fur Práventionsforschung und Soziaimedizin Bremen, Germany
eSwedish Institute for Social Research, Stockholm University Stockholm, Sweden
fGSF-Instituie for Medical Informatics and Health Service Research (MEDIS) D-Neuherberg, Germany
gSocial Survey Division, Office for National Statistics London, UK
hCREDES Paris, France
iDanish Institute for Clinical Epidemiology Copenhagen, Denmark
jSwiss Federal Statistical Office Bern, Switzerland
BACKGROUND: This paper describes morbidity differences according to occupational class among men from France, Switzerland, (West) Germany, Great Britain, the Netherlands, Denmark, and Sweden.
METHODS: Data were obtained from national health interview surveys or similar surveys between 1986 and 1992. Four morbidity indicators were included. For each country, individual-level data on occupation were recoded according to one standard occupational class scheme: the Erikson-Goldthorpe social class scheme. To describe the pattern of morbidity by occupational class, odds ratios (OR) were calculated for each class using the average of the population as a reference. The size of morbidity differences was summarized by the OR of two broad hierarchical classes. All OR were age-adjusted.
RESULTS: For all countries, a lower than average prevalence of morbidity was found for higher and lower administrators and professionals as well as for routine non-manual workers, whereas a higher than average prevalence was found for skilled and unskilled manual workers and agricultural workers. Self-employed men were in general healthier than the average population. The relative health of farmers differed between countries. The morbidity difference between manual workers and the class of administrators and professionals was approximately equally large in all countries. Consistently larger inequality estimates, with no or slightly overlapping confidence intervals, were only found for Sweden in comparison with Germany.
CONCLUSIONS: Thanks to the use of a common social class scheme in each country, a high degree of comparability was achieved. The results suggest that morbidity differences according to occupational class among men are very similar between different European countries.
Keywords Socioeconomic status, occupational class, self-reported, morbidity, health surveys, international comparison
Accepted 8 July 1997
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