Women and children last?

Abstract

Most analyses of the relationship between class position and health outcomes have been restricted to occupational class and male mortality, and most discussions of the function of the health services in relation to class and health have been based on a limited range of hypotheses about the relevance of health service use to health. This paper draws on data from a longitudinal study of a sample of disadvantaged mothers and children in the UK to examine the different dimensions of class associated with maternal and child health outcomes over the first year of life, and to explore the role of formal health service use in relation both to class position and health outcomes. A novel feature of the paper is the use of complementary statistical methods to approach these issues. The findings show that mothers'and children's health are influenced by material conditions, and that these differentiate between ‘the poor and the poorest’; occupationally-defined class position does not discriminate between health outcomes for mothers and children in the same way as it does for men. Within this sample of predominantly disadvantaged mothers and children, use of the formal health services appears to be associated with negative rather than positive health outcomes. The interpretation of these findings is discussed, as are their implications for the future development of European health and welfare services.