How large are the differences ‐ really? Self‐reported long‐standing illness among working class and middle class men

Abstract

AbstractSocial inequalities in health are regularly found in health interview surveys, but it has been doubted whether respondents’ self‐reported morbidity can accurately describe social class differences in health. Two hypotheses are current: members of the working class are commonly more preoccupied with their illnesses, and overreport them, compared with those of the middle class: secondly, the latter are more sensitive to their illnesses, have a better chance of getting them diagnosed, and consequently claim a wider array of illnesses in comparison with the former. This paper analyses answers to questions about long‐standing illness from working class and middle class men, aged 25–64, in Norwegian surveys during the 1980s. Working class respondents experience their illnesses as more serious. An analysis of diagnostic categories of the illnesses of both sets of respondents indicates that this subjective experience is realistic. The hypothesis that a high level of psychological malaise among working class men produces a tendency to somatise psycho‐social stress is not supported. The paper concludes that social inequalities in morbidity as shown by self‐reported long‐standing illness will often underestimate true class differences.