High Occupational Social Class Research Articles

The Political Sociology of Voting Participation in Southern Africa: A Multilevel Study of Regional and Social Class Predictors in 11 Countries

Voting participation constitutes and legitimatizes electoral democracy. However, research has been unable to predict and explain the lack of participation across political contexts. The present study aims to predict voting participation based on regional predictors using 11 countries from the Afrobarometer (2019). For the analysis, the study uses modern measurement models and Bayesian multilevel logit models (binary and categorical). The regional analysis suggests that a greater frequency of experiencing bribery predicts lower voting probabilities. Regions with citizens who are more highly educated predict lower voting probabilities for deciding not to vote. Regions with higher levels of skilled craft workers predict lower voting probabilities. Compared to those in the lower occupational social class, citizens in the higher occupational social class have a lower voting probability. The study concludes by offering implications for the relational approach to contentious politics and democratization.

Assessing Differences in the Implementation of Smoke-Free Contracts-A Cross-Sectional Analysis from the School Randomized Controlled Trial X:IT.

Objective: The X:IT study is a school-based smoking preventive intervention that has previously been evaluated in a large randomized controlled trial (RCT) with good effects. However, the actual effect for participating students depends on the individual implementation. The aim of this study was to examine the implementation of smoke-free contract, which is one of the three main intervention components. Specifically, we examined whether it was implemented equally across family occupational social class (OSC), separately for boys and girls, the joint effect of OSC and gender, and the participants’ own reasons for not signing a contract. Results: Overall, the smoke-free contract was well implemented; 81.8% of pupils (total N = 2.015) signed a contract (girls 85.1, boys 78.6%). We found a social gradient among girls; more than 90% were in OSC group I vs. 75% in group VI. Among boys, however, we found no difference across OSC. Boys in all the OSC groups had about half the odds (i.e., medium OSC boys: OR = 0.48 (95% CI: 0.32–0.72) of having a smoke-free contract compared to girls from a high OSC. Conclusion: future interventions should include initiatives to involve families from all OSC groups and allow for different preferences among boys and girls.

Persistent social inequality in low life satisfaction among adolescents in Denmark 2002–2018

PurposeThe aims were to examine social inequality in low life satisfaction among Danish adolescents and whether the social inequality changes over time. MethodsThe study population was 20,328 11-, 13- and 15-year-olds from the Danish Health Behaviour in School-aged Children (HBSC) study 2002, 2006, 2010, 2014 and 2018 with data about life satisfaction and occupational social class (OSC). Low life satisfaction was defined as values under 6 on the Cantril Ladder. ResultsThe proportion with low life satisfaction was 10.5% in high, 11.7% in medium and 14.7% in low OSC (chi2-test, p < 0.0001). The OR (95% CI) for low life satisfaction was 1.25 (1.13–1.39) in medium and 1.62 (1.43–1.83) in low compared to high OSC. There was no upwards or downwards trend in low life satisfaction over time and the absolute and relative social inequality in low life satisfaction did not change from 2002 to 2018. ConclusionThe study shows that the political ambition on reducing social inequality in health and wellbeing has not been met in relation to low life satisfaction among Danish adolescents.

Trends in social inequality in overweight and obesity among adolescents in Denmark 1998-2018.

The aim was to analyze trends in overweight and obesity in relation to socioeconomic position among Danish adolescents in the 20-year period 1998-2018. The study used data on self-reported height and weight and parents' occupational social class (OSC) from 11-, 13- and 15-year-old schoolchildren in 1998, 2002, 2006, 2010, 2014 and 2018, n = 22,177. The analyses included absolute social inequality in overweight/obesity (prevalence difference between low and high OSC) and relative social inequality (OR for overweight/obesity). In the total sample, the prevalence of overweight and obesity was 9.7% and 1.4%, respectively, with significantly higher prevalence in low than high OSC. There were significantly increasing trends in both overweight and obesity 1998-2018 in low OSC and no significant increase in high OSC. The OR for overweight was 1.59 (1.42-1.74) in middle and 2.16 (1.89-2.46) in low OSC, OR for obesity 1.74 (1.29-2.34) in middle and 2.97 (2.15-4.11) in low OSC. Associations were not modified by survey year. There was a persistent absolute and relative social inequality in overweight and obesity 1998-2018 among Danish adolescents.

Intake of sugar sweetened soft drinks among adolescents: Trends and social inequality in Denmark 2002-2018.

Intake of sugar sweetened soft drinks (SSSD) has decreased among adolescents, but trends in social inequality in SSSD intake are unknown. Examine trends in social inequality in SSSD intake among adolescents in Denmark during 2002-2018. Five Health Behaviour in School-aged Children surveys with data on SSSD intake and parents' occupational social class (OSC) from nationally representative samples of 11, 13 and 15 year olds, n =20,112. The overall prevalence of daily SSSD intake decreased from 10.1% in 2002 to 6.4% in 2018. The prevalence decreased in both high OSC (from 8% to 5%) and middle OSC (from 10% to 6%) but remained around 12% in low OSC. The odds ratio (OR) estimates of low compared with high OSC increased over the years around an overall OR of 2.01 (1.74-2.34). Danish adolescents' SSSD intake decreased during 2002-2018 and was higher the lower the parents' OSC. Thus, social inequality increased during 2002-2018.

Trends in socioeconomic differences in daily smoking among 15-year-old Danes 1991-2014.

Aim: To examine trends in socioeconomic differences in daily smoking among 15-year-old Danes between 1991-2014, using occupational social class as indicator of socioeconomic status. Methods: The study included 15-year-olds participating in seven Danish Health Behaviour in School-aged Children studies between 1991-2014, n = 8,641. The analyses focused on absolute socioeconomic differences (prevalence difference between low and high occupational social class) and relative socioeconomic differences communicated by odds ratio for daily smoking. Results: The prevalence of daily smoking declined from 18.6% in 1991 to 4.5% in 2014. Across all surveys, the prevalence was 8.9% in high, 12.8% in middle and 16.5% in low occupational social classes (p < 0.0001). The absolute socioeconomic differences increased from 1991 to 2006 and declined thereafter. Across all survey years, the odds ratio (95% confidence interval) for daily smoking was 1.40 (1.19-1.65) in middle and 1.90 (1.56-2.32) in low versus high occupational social classes. The statistical interaction between occupational social class and survey year was significant (p = 0.0404), suggesting increasing relative socioeconomic differences from 1991 to 2014. Conclusions: There was a substantial decline in daily smoking among 15-year-olds between 1991-2014 in all occupational social class groups. The prevalence of daily smoking was highest in the low occupational social class during the entire period. The absolute socioeconomic differences in daily smoking increased between 1991-2006 and declined thereafter. The relative socioeconomic differences increased over 1991-2014. Studies of change in socioeconomic differences over time should address both absolute and relative socioeconomic differences as they may result in different conclusions and because important improvement in prevalence patterns may be disguised by exclusive focus on changes in relative socioeconomic differences.

Trends in social inequality in loneliness among adolescents 1991-2014.

Loneliness and social inequality in health are important public health concerns. We examined (i) trends in loneliness among adolescents from 1991 to 2014 in Denmark and (ii) trends in social inequality in loneliness. Study population: 11-15-year olds in random samples of schools in 1991, 1994, 1998, 2006 and 2014, n = 19 096. Loneliness was measured by a single item and social background by parents' occupational social class (OSC). We calculated absolute (%) differences in loneliness between high and low OSC and relative differences by odds ratio for loneliness. Across all surveys, 6.3% reported feeling lonely. The prevalence increased from 4.4% in 1991 to 7.2% in 2014. The prevalence of loneliness in high, middle and low OSC was 5.8, 5.9 and 8.0%. The increase in loneliness was more pronounced in higher than lower OSC, resulting in a decreasing absolute social inequality in loneliness. The statistical interaction between OSC and survey year was significant, P = 0.0176, i.e. the relative social inequality in loneliness also decreased from 1991 to 2014. The prevalence of loneliness increased from 1991 to 2014. The social inequality in loneliness decreased in both absolute and relative terms because of a rising prevalence of loneliness among children from high OSC.

Brief Report: Trends in Social Inequality in Drunkenness Among Danish Adolescents, 1991–2014

This study examined whether social inequality in frequent drunkenness among Danish adolescents changed from 1991 to 2014. We used data from the international Health Behaviour in School-aged Children (HBSC) study, which provided nationally representative samples of 15-year-olds from seven comparable cross-sectional studies in Denmark (N = 8,655). The students provided data about frequency of drunkenness and parents' occupation. In total, 38.6% reported to have been drunk at least four times, decreasing from 44.2% in 1991 to 21.2% in 2014. Most of the decrease took place in the latter part of the period. This decrease was found in all occupational social classes, but there was no change in absolute social inequality in drunkenness four or more times reported from 1991 to 2014. The sex- and yearadjusted odds ratio for frequent drunkenness was 0.80, 95% CI [0.70, 0.93] in low compared with high occupational social class. The statistical interaction between survey year and occupational social class was insignificant (p = .3601); that is, there was no change in relative social inequality in frequent drunkenness over time. Drunkenness was more prevalent among adolescents from the high occupational social class, and this social inequality did not change from 1991 to 2014.

Persistent social inequality in medicine use for headache among adolescents in Denmark 1991-2014.

Socioeconomic variation in adolescents' medicine use behaviour is an understudied issue. To examine the association between socioeconomic background and medicine use for headache among adolescents, and how this association changes over time. Data stem from the Danish part of the international Health Behaviour in School-aged Children (HBSC) study 1991-2014 with data about parents' occupational social class (OSC) and self-reported medicine use for headache, n = 26,685. This study examined absolute social inequality (percent difference between high and low OSC) and relative social inequality (odds ratio for medicine use by OSC). In total, 40.5% used medicine for headache in the past month. There was a significant increase from 32.3% in 1991 to 42.8% in 2002 (test for trend, p < 0.0001) and very little change 2002-2014. This pattern was similar in high, middle and low OSC. The prevalence of medicine use for headache in high, middle and low OSC was 36.2%, 41.5% and 44.8% (p < 0.0001). The OR (95% CI) for medicine use was 1.25 (1.18-1.324) in middle and 1.43 (1.33-1.54) in low OSC. Medicine use for headache increased 1991-2002 and remained stable 2002-2014. There was increasing medicine use for headache with decreasing OSC; this social inequality was persistent 1991-2014.

Persistent social inequality in low intake of vegetables among adolescents, 2002-2014.

To examine the trend in social inequality in low intake of vegetables among adolescents in Denmark from 2002 to 2014 using occupational social class (OSC) as socio-economic indicator. Repeated cross-sectional school surveys including four waves of data collection in 2002-2014. The analyses focused on absolute social inequality (difference between high and low OSC in low vegetable intake) as well as relative social inequality (OR for low vegetable intake by OSC). The nationally representative Health Behaviour in School-aged Children (HBSC) study in Denmark. The study population was 11-15-year olds (n 17 243). Low intake of vegetables was defined as less than weekly intake measured by food frequency items. OSC was measured by student reports of parents' occupation. The proportion of participants who reported eating vegetables less than once weekly was 8·9 %, with a notable decrease from 11·9 % in 2002 to 5·9 % in 2014. The OR (95 % CI) for less than weekly vegetable intake was 2·28 (1·98, 2·63) in the middle compared with high OSC and 3·12 (2·67, 3·66) in the low compared with high OSC. The absolute social inequality in low vegetable intake decreased from 2002 to 2014 but the relative social inequality remained unchanged. The study underscores that it is important to address socio-economic factors in future efforts to promote vegetable intake among adolescents. The statistical analyses of social inequality in vegetable intake demonstrate that it is important to address both absolute and relative social inequality as these two phenomena may develop differently.

Short communication: Persistent socio-economic inequality in frequent headache among Danish adolescents from 1991 to 2014.

The association between socio-economic status (SES) and headache among adolescents is an understudied issue, and no study has examined whether such an association changes over time. The aim was to examine trends in socio-economic inequality in frequent headache among 11- to 15-year-olds in Denmark from 1991 to 2014, using occupational social class (OSC) as indicator of SES. The study applies data from the Danish part of the international Health Behaviour in School-aged Children (HBSC) study. HBSC includes nationally representative samples of 11-, 13- and 15-year-olds. This study combines data from seven data survey years from 1991 to 2014, participation rate 88.6%, n=31,102. We report absolute inequality as per cent difference in frequent headache between high and low OSC and relative inequality as odds ratio for frequent headache by OSC. In the entire study population, 10.4% reported frequent headache. There was a significant increase in frequent headache from 8.0% in 1991 to 12.9% in 2014, test for trend, p<0.0001. This increasing trend was significant in all OSCs. The prevalence of frequent headache was significantly higher in low than high OSC, OR=1.50 (95% CI: 1.34-1.67). This socio-economic inequality in frequent headache was persistent from 1991 to 2014. There was a significant and persistent socio-economic inequality, i.e. increasing prevalence of frequent headache with decreasing OSC. The association between socio-economic position and headache did not significantly change over time, i.e. the statistical interaction between OSC and survey year was insignificant. The prevalence of frequent headache among adolescents increases with decreasing SES. This socio-economic inequality has been persistent among adolescents in Denmark from 1991 to 2014. Clinicians should be aware of this social inequality.

Increasing prevalence of emotional symptoms in higher socioeconomic strata: Trend study among Danish schoolchildren 1991-2014.

Aims: The aims of this study were: (a) to examine trends in daily emotional symptoms among 11- to 15-year-olds from 1991 to 2014 in Denmark, and (b) to examine trends in social inequality in daily emotional symptoms, that is, whether the differences in prevalence between adolescents with parents of varying occupational social class changed over time. Methods: We combined seven comparable cross-sectional Health Behaviour in School-aged Children surveys (N=31,169). Daily emotional symptoms were measured by the HBSC Symptom Check List and occupational social class (OSC) by students' reports about parents' occupation. We calculated absolute (per cent) differences in emotional symptoms between high and low OSC and relative differences by odds ratio for emotional symptoms by parents' OSC. Results: Eight per cent reported at least one daily emotional symptoms, with an increasing trend from 1991 to 2014 (p<0.001). The prevalence in high, middle and low OSC was 6.2%, 7.4% and 10.6% (p<0.0001). From 1991 to 2014, there was an increase in the prevalence of daily emotional symptoms in high (p<0.0001) and middle (p<0.0001) but not low OSC (p=0.4404). This resulted in a diminishing absolute social inequality in emotional symptoms. The statistical interaction between OSC and survey year was significant (p=0.0023) and suggests a diminishing relative social inequality in emotional symptoms from 1991 to 2014. Conclusions: There was an increasing prevalence of daily emotional symptoms from 1991 to 2014 and a diminishing social inequality in prevalence of daily emotional symptoms in terms of both absolute and relative social inequality.

Occupational Social Class and Personality Traits in Relation to Leisure-Time Physical Activity Level: Cross-Sectional Results From the Copenhagen Aging and Midlife Biobank.

To investigate separate and combined associations of occupational social class and personality traits with late midlife leisure-time physical activity duration and intensity. Cross-sectional data from the Copenhagen Aging and Midlife Biobank ( N = 4,649) were analyzed using linear regression models with leisure-time physical activity (metric equivalence) as outcome. Low versus high occupational social class was associated with 4% (95% confidence interval [CI] = [3%, 5%]) greater leisure-time physical activity duration, but 2% (CI = [1%, 3%]) lower intensity. Each 10-unit increase in extraversion was associated with 5% (CI = [2%, 8%]) greater duration. Intensity increased by each 10-unit increase in conscientiousness (6%, CI = [4%, 7%]), openness (3%, CI = [1%, 4%]), neuroticism (3%, CI = [1%, 4%]), and extraversion (5%, CI = [4%, 7%]). Conscientiousness was positively associated with duration in low, but not in high, occupational social class (interaction p value = .002). Higher occupational social class was associated with lower leisure-time physical activity duration, but higher intensity. Extraversion was positively associated with duration and intensity. Conscientiousness, openness, and neuroticism were positively associated with intensity. Overall, interactions were not consistent.

Socioeconomic indicators and sociobehavioural mediators of high mental wellbeing despite low physical capability: the MRC National Survey of Health and Development

BackgroundWhen presented with challenges that accompany ageing, such as reduced physical capability, some individuals respond more positively than others, maintaining higher levels of wellbeing than expected (ie, they are resilient). Although socioeconomic advantage is positively associated with individual (internal) and external resources that promote resilience in some contexts, the association between socioeconomic status (SES) and resilience is not known. We aimed to examine the association between SES and the chance of maintaining high wellbeing despite low physical capability, and to assess the degree to which social support and physical activity mediate this association. MethodsParticipant data at age 60–64 years came from the MRC National Survey of Health and Development, a nationally representative birth cohort study. Resilience was operationalised as having a greater than expected level of wellbeing, captured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), given the level of performance-based physical capability, assessed by grip strength, chair rise, standing balance, and timed up and go tests. Degree of resilience was quantified as the difference between observed and predicted WEMWBS score (ie, residual values) for physical capability by linear regression. SES was assessed by occupational class of head of household at age 53 years. Structural equation models with full information maximum likelihood estimation were estimated (Stata version 14) to assess mediation of SES and resilience by social support and physical activity. Findings1756 study participants (934 [53%] female, 822 [47%] male) had complete WEMWBS and physical capability data. A positive association between higher occupational social class and greater resilience was demonstrated in a sex-adjusted model (β=1·02, 95% CI 0·22–1·81; p=0·012) (13% of an SD per SES category). Physical activity (1·23, 0·47–1·99; p=0·002) and social support (0·22, 0·17–0·26; p<0·001) were positively associated with greater resilience. Physical activity partly mediated (5·9%) the association between SES and resilience but there was no association between SES and social support, so no mediation was observed. InterpretationThese results show that higher SES was associated with greater resilience—ie, having a greater than expected level of wellbeing given the level of performance-based physical capability. Physical activity partly mediated the association between SES and resilience, suggesting that greater resilience can be fostered through physical activity. FundingUK Medical Research Council (programme code MC_UU_12019/1, MC_UU_12019/4, and MC_UU_12019/5). TDC is supported by a Canadian Institutes of Health Research postdoctoral fellowship (MFE-146676).

Role of psychosocial work factors in the relation between becoming a caregiver and changes in health behaviour: results from the Whitehall II cohort study

BackgroundThe present study tested the effects of becoming a caregiver combined with adverse working conditions on changes in health behaviours.MethodsParticipants were 5419 British civil servants from the Whitehall II cohort...

Socioeconomic inequalities in the healthiness of food choices: Exploring the contributions of food expenditures

Investigations of the contribution of food costs to socioeconomic inequalities in diet quality may have been limited by the use of estimated (vs. actual) food expenditures, not accounting for where individuals shop, and possible reverse mediation between food expenditures and healthiness of food choices. This study aimed to explore the extent to which food expenditure mediates socioeconomic inequalities in the healthiness of household food choices. Observational panel data on take-home food and beverage purchases, including expenditure, throughout 2010 were obtained for 24,879 UK households stratified by occupational social class. Purchases of (1) fruit and vegetables and (2) less-healthy foods/beverages indicated healthiness of choices. Supermarket choice was determined by whether households ever visited market-defined high-price and/or low-price supermarkets. Results showed that higher occupational social class was significantly associated with greater food expenditure, which was in turn associated with healthier purchasing. In mediation analyses, 63% of the socioeconomic differences in choices of less-healthy foods/beverages were mediated by expenditure, and 36% for fruit and vegetables, but these figures were reduced to 53% and 31% respectively when controlling for supermarket choice. However, reverse mediation analyses were also significant, suggesting that 10% of socioeconomic inequalities in expenditure were mediated by healthiness of choices. Findings suggest that lower food expenditure is likely to be a key contributor to less-healthy food choices among lower socioeconomic groups. However, the potential influence of cost may have been overestimated previously if studies did not account for supermarket choice or explore possible reverse mediation between expenditure and healthiness of choices.