National Statistics Socio-economic Classification Research Articles

Demographic characteristics of those who cycle commute and the effect access to on- and off-road cycle paths has on cycle commute uptake.

ObjectivesIncreasing cycle commute uptake could be an important approach to improving worker health and reducing carbon emissions, congestion and air pollution. In order to increase cycle commute uptake, we must understand the characteristics of those who already cycle to work and the aspects of physical infrastructure that could promote cycling. MethodsIn this work, we use administrative data pertaining to those in employment aged 16-74 years living and working in Glasgow and Edinburgh, Scotland on the night of the 2011 population census. We calculate distances to the nearest cycle path for each individual from cycle route data from around the time of the census that were made computer readable. We looked at the characteristics of those who cycled to work and how proximity to nearest cycle path differed between groups along with how distance from place of residence and place of work to nearest cycle path influenced cycle commute uptake. ResultsWe show how the propensity to cycle commute differs across population characteristics such as sex, age and the National Statistics Socio-economic classification and how the interaction of these factors affects propensity to cycle commute. We also show the ways in which living and working closer to on- and off-road cycle paths increases the likelihood of cycle commuting. DiscussionThe results of this study can be used to inform the most promising groups to aim cycling interventions at thereby improving health and environmental outcomes.

Sociodemographic and health-related differences in undiagnosed hypertension in the health survey for England 2015–2019: a cross-sectional cohort study

Hypertension is a leading cause of morbidity and mortality worldwide, yet a substantial proportion of cases are undiagnosed. Understanding the scale of undiagnosed hypertension and identifying groups most at risk is important to inform approaches to detection. In this cross-sectional cohort study, we used data from the 2015 to 2019 Health Survey for England, an annual, cross-sectional, nationally representative survey. The survey follows a multi-stage stratified probability sampling design, involving a random sample of primary sampling units based on postcode sectors, followed by a random sample of postal addresses within these units. Within each selected household, all adults (aged ≥16 years) and up to four children, were eligible for participation. For the current study, individuals aged 16 years and over who were not pregnant and had valid blood pressure data were included in the analysis. The primary outcome was undiagnosed hypertension, defined by a measured blood pressure of 140/90mmHg or above but no history of diagnosis. Age-adjusted prevalence of undiagnosed hypertension was estimated across sociodemographic and health-related characteristics, including ethnicity, region, rural-urban classification, relationship status, highest educational qualification, National Statistics Socio-Economic Classification (NS-SEC), Body Mass Index (BMI), self-reported general health, and smoking status. To assess the independent association between undiagnosed hypertension and each characteristic, we fitted a logistic regression model adjusted for sociodemographic factors. The sample included 21,476 individuals, of whom 55.8% were female and 89.3% reported a White ethnic background. An estimated 30.7% (95% confidence interval 29.0-32.4) of men with hypertension and 27.6% (26.1-29.1) of women with hypertension were undiagnosed. Younger age, lower BMI, and better self-reported general health were associated with an increased likelihood of hypertension being undiagnosed for men and women. Living in rural areas and in regions outside of London and the East of England were also associated with an increased likelihood of hypertension being undiagnosed for men, as were being married or in a civil partnership and having higher educational qualifications for women. Hypertension is commonly undiagnosed, and some of the groups that are at the lowest risk of hypertension are the most likely to be undiagnosed. Given the high lifetime risk of hypertension and its strong links with morbidity and mortality, our findings suggest a need for greater awareness of the potential for undiagnosed hypertension, including among those typically considered 'low risk'. Further research is needed to assess the impact of extending hypertension screening to lower-risk groups. None.

Sociodemographic inequalities of suicide: A population-based cohort study of adults in England and Wales 2011-2021

ObjectivesWith suicide a major public health concern, it is vital research identifies predictors of suicide to support vulnerable groups who should be targeted for intervention. We use a novel linkage of 2011 Census and population level mortality data to assess which risk factors are important predictors of suicide.
 MethodsExposures of interest were identified from Census 2011 and were sex, age, ethnicity, marital status, day-to-day impairments, religion, region, National Statistics Socio-economic Classification. Our study population consisted of 35,136,917 people aged 18-to-74; there were 35,928 suicides in our study period (28/03/2011-31/12/2021), with 73.9\% occurring in men. We fitted generalised linear models with a Poisson link function, with suicide being the outcome of interest. The natural logarithm of exposure time was included as an offset term. To estimate rates of suicide per 100,000 people for each level of our exposure, by sex for the average age, we calculated marginal means.
 ResultsThe groups with the highest rates of suicide were those who reported an impairment affecting their day-to-day activities, those who were long term unemployed or never had worked, or those who were single or separated. Comparison of minimally adjusted models with models accounting for all other characteristics identified predictors which remain important risk factors after accounting for other characteristics; day-to-day impairments were still found to increase the incidence of suicide relative to those whose activities were not impaired after adjusting for employment status. Additionally, the estimated rates of suicide remained lowest in London compared to other regions in our fully adjusted estimates. Overall, rates of suicide were higher in men compared to females across all ages, with the highest rates in 40- to 50-year-olds.
 ConclusionThe findings of this work provide novel population level insights into the risk of suicide by sociodemographic characteristics, this work should pave the way for further research exploring the interaction of factors which lead to suicide and drive policy change for targeted intervention.

Education mediates the relationship of parental socioeconomic status with subjective adult oral health

BackgroundEvidence shows that both socioeconomic status (SES) during childhood and education are associated with adult oral health. However, whether the range of opportunities families have regarding their children’s education mediate the effect of childhood disadvantage on oral health later in life remains unknown. The aim of this study was to evaluate the mediating role of education in the association between parental SES and subjective oral health status in middle adulthood.MethodsData from 6703 members of the British Cohort Study 1970 were analyzed. Parental SES was measured using the 7-class National Statistics Socio-Economic Classification (NS-SEC) at age 10 years. Five measures of education (type of high school, highest qualification, age left full-time education, status of institution and field of study) were obtained from ages 16 and 42 years. Subjective oral health was measured with a single global item at age 46 years. Causal mediation analysis was performed, using a weighting-based approach, to evaluate how much of the effect of parental SES on subjective oral health was mediated by the measures of education separately and jointly.ResultsOverall, 23.6% of individuals reported poor oral health. Parental SES was associated with every measure of education, and they were also associated with subjective oral health in regression models adjusted for confounders. The effect of parental SES on subjective oral health was partially mediated by each measure of education, with a proportion mediated of 53.2% for the institution status, 46.5% for the field of study, 42.8% for the school type, 38.9% for the highest qualification earned and 38.4% for the age when full-time education was discontinued. The proportion of the effect of parental SES on subjective oral health jointly mediated by all measures of education was 81.1%.ConclusionThis study found a substantial mediating role of education in the association between parental SES and subjective oral health in middle adulthood.

Study protocol: examining the impacts of COVID-19 mitigation measures on pregnancy and birth outcomes in Scotland—a linked administrative data study

IntroductionThis protocol outlines aims to test the wider impacts of the COVID-19 pandemic on pregnancy and birth outcomes and inequalities in Scotland.Method and analysisWe will analyse Scottish linked administrative data...

P094 Occupation and work productivity in individuals with early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit

Abstract Background/Aims To continue working, work in the same occupation or work the same number of hours is one of the most important outcomes for individuals with inflammatory arthritis but is often diminished during the very early phases of disease. Our objectives were to describe occupation and work status in individuals with early inflammatory arthritis (EIA) from the National Early Inflammatory Arthritis Audit (NEIAA) and assess the impact of occupation and treatment response on work disability. Methods NEIAA is an observational cohort of adults with newly diagnosed EIA seen in rheumatology services in England and Wales between May 2018 and March 2020. Self-reported occupation was coded using the UK Standard Occupational Classification and classified using the National Statistics Socio-Economic Classification (NS-SEC). Work disability was assessed at diagnosis, 3 months, and 12 months, using the work productivity and activity impairment (WPAI) score, with absenteeism data dichotomized between those who reported any sick-leave and those who did not. Multilevel mixed-effects linear regression models were used to examine associations between occupation and WPAI score at baseline and over 12 months. Variables for adjustment were decided a priori and included only age and sex. Results There were 12,663 individuals with EIA, with 5999 (48%) in paid work defined as greater than 20 hours per week. Occupation data were available for 3720 individuals, with the highest proportion of patients in lower managerial, administrative, professional (n = 773) and semi-routine (n = 761) roles. At diagnosis, 171 patients (4.7%) had stopped work and 336 (9.2%) had changed jobs because of their EIA. Absenteeism was reported by 685 patients (29.5%). Compared to the higher managerial, administration and professional occupation group, the other occupational types demonstrated a greater level of productivity loss due to presenteeism and overall work impairment. Individuals in semi routine and routine occupations were more likely to stop work due to EIA. In the 12 months after diagnosis, absenteeism, presenteeism and overall impairment improved across all occupations. Achieving a good EULAR response at 3 months, but not occupational type, was associated with improvement in work outcomes over time (p value <0.001). Conclusion Work disability is prevalent in individuals with EIA at diagnosis, with variation across occupation types. In the first 12 months after diagnosis improvements in all work outcomes are seen, with the greatest change in those who achieve a good EULAR response. Disclosure K. Bechman: None. E. Cook: None. A. Houssien: None. P. Amlani-Hatcher: None. J. Ledingham: None. J. Galloway: Consultancies; Sanofi, Novartis, Pfizer, Janssen, UCB. Grants/research support; Eli Lilly. K. Walker-Bone: None.

Is social origin, destination or mobility what matters to adult self-rated oral health?

To evaluate the independent contributions of parental socioeconomic position (SEP), own SEP and social mobility to explain adult self-rated oral health. Data from 6633 participants in the 1970 British Cohort Study were analysed. Parental SEP at the age of 10years (social origin) and own SEP at the age of 46years (social destination) were indicated by the 7-class National Statistics Socioeconomic Classification (NS-SEC). The study outcome was self-rated oral health (SROH) at the age of 46years. Diagonal reference models (DRMs) were used to parse out the effects of parental SEP, own SEP and intergenerational mobility from childhood to middle adulthood, after adjusting for demographic characteristics (sex, ethnicity, country and area of residence). Overall, 23.1% of participants reported poor SROH. A baseline DRM, with no indicators of social mobility, showed that the contribution of own SEP to explain variations in SROH was higher than that of parental SEP. However, they became almost equal after indicators of social mobility were introduced. Downward mobility was associated with poor SROH (odds ratio: 1.24, 95% CI: 1.01-1.51), but upward mobility was not (1.01, 95% CI: 0.83-1.23). Also, short-range downward mobility and long-range downward mobility (moving 1 and 2+ social classes down in NS-SEC, respectively) were associated with poor SROH (1.26, 95% CI: 1.01-1.58 and 1.39, 95% CI: 1.06-1.83, respectively) whilst short-range upward mobility (1.04, 95% CI: 0.84-1.28) and long-range upward mobility (0.88, 95% CI: 0.67-1.14) were not. The contributions of parental and own SEP were similar once social mobility was accounted for. Only downward mobility was associated with poor SROH, with new evidence that long-range mobility was more strongly associated with poor SROH than short-range mobility.

Fractures of the Mandible: Epidemiological Study of 519 Nigerian Cases.

Background:Epidemiological studies despite their limitations provide information that is useful for the formulation of effective and efficient injury prevention strategies.Aim:The aim is to carry out epidemiology study of mandibular fracture in a Nigerian population.Setting:Department of Oral and Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria.Materials and Methods:A retrospective observational study was carried out at the Ahmadu Bello University Teaching Hospital, Shika-Zaria. Data retrieved from patients’ case notes and operating records were subjected to statistical analysis involving frequencies (count, percent), measures of central tendency (mean), and measures of dispersion (standard deviation) using Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL). Mandibular fracture was classified based on sites, and patients’ socioeconomic status was classified based on United Kingdom National Statistics Socio-economic Classification (NS-SEC, 2010).Results:There were 466 (89.9%) males and 53 (10.1%) females. Based on Socio-economic Classification (NS-SEC, 2010), there was a preponderance of analytical class 6 (n = 217; 54.9%) and 8 (n = 127; 32.2%). Road traffic–related accident (n = 385; 74.2%) was the most common aetiological factor, and a total of 215 (41.4%) patients had a record of loss of consciousness. The mandibular body (n = 225; 32.0%) followed by the parasymphyseal (n = 187; 26.6%) regions were the most fractured sites. Closed-reduction technique was the predominant treatment modality.Conclusions:A road traffic accident was the most common aetiological factor for mandibular fracture, and the mandibular body had the highest frequency of fractures. Measures aimed at injury prevention should be continually reviewed and updated to limit the morbidity and economic burden on individuals.

A break in the gradient: relational social class and high-impact chronic pain

The association between socioeconomic status (SES) and health is usually depicted by a monotonic gradient, where higher SES is associated with better health outcomes. We aimed to investigate whether the association between high-impact chronic pain (HICP) and a newly adapted measure of social class was consistent with relational class theories predicting non-gradient patterns. This study included a nationally-representative sample of 50,860 adults aged ≥25 years who had ever worked, from the National Health Interview Survey 2016-2017. HICP was defined as pain that interferes with life or work activities on most days or every day for 6 months or longer. We constructed a 5-category measure of relational social class based on the UK National Statistics Socio-Economic Classification (NS-SEC), using occupational codes, employment type and firm size (managerial and professional occupations, intermediate occupations, small employers and own account workers, lower supervisory and technical occupations, semi-routine and routine occupations). We used Poisson regression weighted for survey sampling, adjusted for age, sex, race, ethnicity, US citizenship, marital status, education and census region to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association between social class and HICP. HICP prevalence was similar between the reference class, managerial and professional occupations, and intermediate occupations (PR=0.99, 95% CI 0.88, 1.12); both lower than all other classes. Despite not being hierarchically lowest, lower supervisory and technical occupations had the highest prevalence of HICP relative to the reference class (PR=1.37, 95% CI 1.23, 1.53). That was higher than semi-routine and routine occupations (PR= 1.27, 95% CI 1.15, 1.40), and small employers and own account workers (PR=1.27, 95% CI 1.10, 1.47). HICP prevalence by social class is compatible with the concept of ‘contradictory class location’. Relational class measures can provide insight into the complexity of socioeconomic position and illuminate potential targets for interventions to reduce pain disparities. Scan|Design Foundation Innovative Pain Research Grant (2019), American Academy of Orofacial Pain Research Grant (2019).

Socio-economic distribution of e-cigarette use among recent former regular smokers and current smokers at ages 25-26 in England.

Background and aimsE‐cigarettes may potentially help young adult smokers to quit smoking, yet little is known about differences among socio‐economic groups. We examined associations between key socio‐economic characteristics and e‐cigarette use among recent former smokers and current smokers in a sample of young adults in England.Design, setting, participants and measurementsWe used data on 346 recent former regular (daily for 12+ months) smokers and 1913 current smokers from the ages 25–26 wave of the Next Steps cohort study (2015–2016). In multinomial logistic regression, we estimated relative risk ratios (RRR) of e‐cigarette use (never, former, non‐daily, daily) by educational attainment, social class [using the National Statistics Socio‐economic classification (NS‐SEC)] and employment status [full‐time, part‐time, unemployed and other ‘inactivity’ (e.g. stay‐at‐home parents and permanantly disabled)], adjusting for sex.FindingsAmong recent former regular smokers, there were no patterns of association between socio‐economic characteristics and e‐cigarette use. Among current smokers: (1) compared with higher occupation (NS‐SEC I/II), intermediate occupation (NS‐SEC III/IV) was positively associated with non‐daily e‐cigarette use [RRR = 1.77, 95% confidence interval (CI) = 1.03–3.03]; (2) compared with full‐time employment, unemployment was negatively associated with non‐daily and daily e‐cigarette use (RRR = 0.38, 95% CI = 0.18–0.81; RRR = 0.12, 95% CI = 0.02–0.56) and other economic inactivity was negatively associated with daily e‐cigarette use (RRR = 0.39, 95% CI = 0.16–0.93).ConclusionsAmong young adult smokers in England, lower‐status occupational groups were more likely to use e‐cigarettes on a non‐daily basis than to have never used compared with higher status occupational groups. Compared with people in full‐time employment, those without employment were less likely to use e‐cigarettes daily than to have never used.

Social class inequalities in educational attainment: measuring social class using capitals, assets and resources

ABSTRACT There is a plethora of measures of social class, and social stratification more widely. Occupation-based measures are most frequently used in social stratification research, although more recently the propriety of such approaches have been questioned. An emerging school of thought advocates the use of more culturally based measures as the most appropriate indicators of an individual’s social class position, an argument predominantly influenced by the work of Bourdieu. In this paper, we evaluate the benefits of a social class measure with a Bourdieusian theoretical foundation compared with an orthodox neo-Weberian occupation-based social class measure, the National Statistics Socio-economic Classification (NS-SEC). First, we assess how closely we can replicate the Bourdieusian social class measure reported in Savage et al. ([2013]. A new model of social class: Findings from the BBC's Great British class survey experiment. Sociology). Second, we aim to compare and contrast the capitals, assets and resources based social class measure with the occupation-based National Statistics Socio-economic Classification, in an analysis of inequalities in school GCSE outcomes.

Development and validation of a social position measure in Greece

Abstract Background A valid measure of social position is important for investigating health inequalities. The registrar general classification is not theoretically based or validated and it is based only on occupation. On the other hand, the National Statistics Socio-economic Classification (NS-SeC) distinguishes between different social positions in terms of both their typical labour market and work situations. The aim of this study was to validate the NS-SeC in a Greek population. Methods A cross-sectional study was conducted in 2018 in Athens, Greece. Participants were classified in one of the seven social position classes of NS-SeC based on their responses to questions related to their occupation, employment status (employer, self-employed or employee), supervisor or manager and number of employees in the workplace. Participants were also asked to rate their general health over the previous 12 months in one of three categories: “good”, “fairly good”, or “not good”. The multivariable logistic regression model was used to investigate the predictive validity of NS-SeC. Results 73 individuals with a mean age 43.2 (sd = 11.5) participated in the study. The 46.6% of the participants belonged to the class “managerial and professional occupations”, the 20.5% to the class “intermediate occupations”, while the 31.5% belonged to the class “routine and manual occupations”. The adjusted odds ratio (OR) for “fairly good” or “not good” general health was five times higher in the “routine and manual occupations” in comparison to the combine group of the other two classes (OR: 5.1; 95% Confidence Interval: 1.4-18.2). Conclusions The Greek version of NS-SeC has an excellent predictive validity and it is considered a valid measure of social position in a Greek population. Therefore, it can be used by public health authorities and public health researchers to investigate health inequalities attributed to socio-economic conditions. Key messages The Greek National Statistics Socio-economic Classification is a valid measure of socio-economic position. The Greek National Statistics Socio-economic Classification could be used by public health authorities and public health researchers to investigate health inequalities.

Social distancing, population density, and spread of COVID-19 in England: a longitudinal study.

BackgroundThe UK government introduced social distancing measures between 16–22 March 2020, aiming to slow down transmission of COVID-19.AimTo explore the spreading of COVID-19 in relation to population density after the introduction of social distancing measures.Design & settingLongitudinal design with 5-weekly COVID-19 incidence rates per 100 000 people for 149 English Upper Tier Local Authorities (UTLAs), between 16 March and 19 April 2020.MethodMultivariable multilevel model to analyse weekly incidence rates per 100 000 people; time was level-1 unit and UTLA level-2 unit. Population density was divided into quartiles. The model included an interaction between week and population density. Potential confounders were percentage aged ≥65, percentage non-white British, and percentage in two highest classes of the National Statistics Socioeconomic Classification. Co-variates were male life expectancy at birth, and COVID-19 prevalence rate per 100 000 people on March 15. Confounders and co-variates were standardised around the mean.ResultsIncidence rates per 100 000 people peaked in the week of March 30–April 5, showing higher adjusted incidence rate per 100 000 people (46.2; 95% confidence interval [CI] = 40.6 to 51.8) in most densely populated ULTAs (quartile 4) than in less densely populated ULTAs (quartile 1: 33.3, 95% CI = 27.4 to 37.2; quartile 2: 35.9, 95% CI = 31.6 to 40.1). Thereafter, incidence rate dropped in the most densely populated ULTAs resulting in rate of 22.4 (95% CI = 16.9 to 28.0) in the week of April 13–19; this was lower than in quartiles 1, 2, and 3, respectively 31.4 (95% CI = 26.5 to 36.3), 34.2 (95% CI = 29.9 to 38.5), and 43.2 (95% CI = 39.0 to 47.4).ConclusionAfter the introduction of social distancing measures, the incidence rates per 100 000 people dropped stronger in most densely populated ULTAs.

P134 Patient empowerment in inflammatory bowel disease (IBD): early education at a new diagnosis IBD clinic (NDC)

Abstract Background IBD is a chronic condition that affects young and older people. Co-existing diseases are common. Patient-centred care includes education and support to empower patients and is a recognised dimension of high-quality care. Patient empowerment with knowledge, skills and confidence (‘patient activation’) is associated with better outcomes in many chronic diseases. We aimed to measure patient activation in recently diagnosed IBD patients and to identify factors associated with levels of activation. Methods A NDC was set up at St Mark’s Hospital to offer patients education, information resources and signposts to verified information sources. Patient activation was measured using the Patient Activation Measure (PAM®) tool (Insignia Health) before and after the first consultation. PAM® is a validated questionnaire with 13 questions to generate an activation score ranging from 1 to 4. Non-activation was defined as PAM levels 1 and 2. Demographic (age in years (SD)), disease specific characteristics and anxiety (Generalised Anxiety Disorder Scale, GAD-2) and depression [Patient Health Questionnaire (PHQ-2)] data were collated at the first visit. The National Statistics Socio-economic classification (NS-SEC) was used to classify socio-economic status (SES). Categorical variables were analysed with chi-square test and numerical variables with Student’s t-test. Results Twenty-nine patients (51.7% male) attended NDC (ulcerative colitis = 15, Crohn’s disease = 10, unclassified IBD = 4). 28 completed PAM questionnaires. Mean age was 43.2 ( ± 16.4). 5/28 had a family history of IBD, 6/28 were smokers, 11/28 had another chronic condition, and 16/28 were of non-White ethnic background. Sixty-nine% had active disease. SES and psychological scores were available for 14/28 and 16/28 patients, respectively. Fifty per cent (14/28) of patients were non-activated before NDC; 57.1% (8/14) showed an improvement in activation after NDC. Mean age for activated and non-activated patients was 40.6 ( ± 19.0) and 46.6 ( ± 13.9), respectively (p = 0.35). There was no association between gender, family history, smoking, co-morbidity, ethnic background and SES with activation. None of the four patients (4/16) who scored for anxiety or depression were activated compared with 50% (6/12) of non-anxious/depressed patients (p = 0.07). No patients (0/7) in intermediate or higher SES were activated compared with 43% (3/7) of lower SES (p = 0.05). Conclusion Most non-activated patients had improved activation after attending NDC. Anxiety and depression may contribute to non-activation. Early assessment of patient activation may guide healthcare providers to offer individualised support. Further studies to evaluate the sustainability of patient activation and its effect on clinical outcomes are ongoing.

Male suicide trends and inequalities in Scotland 1980–2015: a population-based study

BackgroundIn Scotland, male suicide rates increased substantially in the 1980s and 1990s with higher rates in more deprived areas. We aimed to examine trends in male suicide in Scotland on an extended time scale (1980–2015) by method of suicide and individual socioeconomic position. MethodsRecords of suicide deaths for 1980–2015 were obtained from National Records Scotland. National Statistics socioeconomic classification (NS-SEC, 2001) was used to assess inequalities in 2000–02 for ages 20–59 years. Standardised death rates were calculated by age with the European population 2013 as reference, and Poisson regression used to determine the significance of trends. Inequalities were assessed with the slope of index of inequality (SII). Findings12 281 suicide deaths were recorded between 1980 and 2015. At all ages, no significant linear trend was observed over time, but suicide rates (per 100 000 person-years) increased from 21 to 27 between 1980 and 2002 (p<0·0001), and decreased from 27 to 20 between 2002 and 2015 (p<0·0001). No significant trend was observed for poisoning, but suicide by hanging, suffocation, and strangulation increased over time (p<0·0001), and decreased for other suicide (p<0·0001). There were significant differences in suicides rates between the NS-SEC groups, and by suicide method (all p<0·0001). The suicide rate in 2000–02 was 27 per 100 000 person-years and the SII (78 per 100 000) showed the difference between social class extremes. Suicide by hanging, suffocation, and strangulation (SII 34 per 100 000) accounted for 44% of the inequalities. InterpretationDecline in male suicide rates may be attributed to suicide prevention strategies introduced by the Scottish Government from 2002 (such as Choose Life). Despite decreasing trends of male suicide, suicide by hanging, suffocation, and strangulation increased over time. Limitations are that trends in inequalities were not available, and the 13% of deaths in the NS-SEC categories, never worked and long term unemployed and not classified, were excluded from the analysis assessing inequalities since the interpretation of results for this group was ambiguous. What effect this omission would have on the estimation of inequalities is unclear. Policy should be directed at reducing deaths from hanging, suffocation, and strangulation. FundingUK Medical Research Council (MC_ UU_12017/13) and Chief Scientist Office (SPHSU13).

Risk factors for childhood obesity: a data analysis of the Welsh Health Survey.

Background The prevalence of childhood obesity in Wales is 12%. It has been estimated that obesity will cost the NHS £10 billion a year by 2050 ( Government Office for Science 2007 ). Aim To determine important risk factors associated with childhood obesity from the data in the Welsh Health Survey 2008 to 2012. Method The analysis used survey data from 11,279 children aged 4-15 years. The lifestyle variables considered as potential risk factors for obesity included: intake of sugar-sweetened drinks; unhealthy food consumption; physical activity; and currently-treated illnesses. The sociodemographic and socioeconomic factors included: sex; age; Welsh Index of Multiple Deprivation quintile; National Statistics Socio-economic Classification; and housing tenure. Results A total of 1,582 (20%) children were obese. A significant association was found between obesity and having one illness - odds ratio (OR) 1.20 (95% confidence interval (CI): 1.05 to 1.38, P=0.008) and having two or more illnesses - OR 1.50 (95% CI: 1.22 to 1.85, P<0.001), and not meeting the physical activity recommendation - OR 1.33 (95% CI: 1.17 to 1.52, P<0.001). Conclusion Every child should meet the physical activity recommendation and those with an illness should receive a care plan to prevent or manage obesity, although this is difficult in the time available for children in clinics and consultations.

Occupational Stratification in Contemporary Britain: Occupational Class and the Wage Structure in the Wake of the Great Recession

Occupations traditionally played a central role in stratification accounts. In the wake of the Great Recession, debates regarding the extent and nature of occupational stratification have been reinvigorated. An exploration of occupational wage stratification patterns defined by both detailed occupational unit groups and the broader occupational class categories of the National Statistics Socio-Economic Classification (NS-SEC) reveals the proportion of wage inequality between occupations and occupational classes has remained broadly stable 1997 to 2015. No compelling evidence is found for growing wage inequalities between detailed occupations within NS-SEC categories. This article underlines the continued utility of occupations and particularly the NS-SEC grouping of them in describing the structure of stratification in contemporary Britain.

Mortality, Greenhouse Gas Emissions, and Consumer Cost Impacts of Replacing Short Car Trips with Cycling: A Health Impact Assessment Study

Background Physical inactivity is important risk factors for poor health. Replacing short car trips with active travel, such as cycling, provides practical way to incorporate physical activity for everyday life. Such change would also help to reduce fuel costs and transport related greenhouse gas (GHG) emissions. In this study we quantified changes in mortality, GHG emissions, and consumer costs for number of travel scenarios. Methods We used National Travel Survey to estimate number and distance of the short car trips in England. All trips less than 1, 2, 3, 5 and 8 miles long were progressively replaced with cycling by taking into account speed of the average cyclist. For each replaced trip, age, gender and SES of the traveller was recorded. The SES was measured by using the National Statistics Socio-Economic Classification (NS-SEC) system, which is an occupation based classification of SES widely used in the UK. The health benefits were illustrated by estimating changes in physical activity related all-cause mortality. Consumer cost savings were estimated based on average fuel prize and GHG emissions based on the average emission of the private car. All calculations were performed on the working age population (20 to 69 year old) of England, totaling 34.2 million adults. Results Premature mortality was reduced by between 75, 811, 2284, 4904 and 7648 cases per year for 1, 2, 3, 5 and 8 miles scenarios, respectively. Mortality reductions were greatest amongst people of medium and high SES. Similarly transport fuel costs savings fell more for people of high SES. Net GHG emissions decreased by between 0.2 and 10.6 Million tons of carbon dioxide equivalent (MtCO2e) per year for the 1 mile and 8 mile scenarios, respectively, representing 0.5% and 19% reduction in national transport related GHG emissions. Conclusions Replacing short car trips with cycling offers the potential for net benefits for health, GHG emissions and consumer costs. These results give quantitative information on potential health, GHG emission and consumer cost changes that replacing short car trips could achieve in population level.

Who Tweets in the United Kingdom? Profiling the Twitter Population Using the British Social Attitudes Survey 2015

The headache any researcher faces while using Twitter data for social scientific analysis is that we do not know who tweets. In this article, we report on results from the British Social Attitudes Survey (BSA) 2015 on Twitter use. We focus on associations between using Twitter and three demographic characteristics—age, sex, and class (defined here as National Statistics Socio-Economic Classification [NS-SEC]). In addition to this, we compare findings from BSA 2015, treated as ground truth (known characteristics), with previous attempts to map the demographic nature of UK Twitter users using computational methods resulting in demographic proxies. Where appropriate, the datasets are compared with UK Census 2011 data to illustrate that Twitter users are not representative of the wider population. We find that there are a disproportionate number of male Twitter users, in relation to both the Census 2011 and previous proxy estimates; that Twitter users are predominantly young, but there are more older users than previously estimated; and that there are strong class effects associated with Twitter use.

An old model of social class? Job characteristics and the NS-SEC schema

This article explores the relationship between the job characteristics underlying the Goldthorpe model of social class (work monitoring difficulty and human asset specificity) and those underlying theories of technological change (routine and analytical tasks) highlighted as key drivers for growing inequality. Analysis of the 2012 British Skills and Employment Survey demonstrates monitoring difficulty and asset specificity predict National Statistics Socio-Economic Classification (NS-SEC) membership and employment relations in ways expected by the Goldthorpe model, but the role of asset specificity is partially confounded by analytical tasks. It concludes that while the Goldthorpe model continues to provide a useful descriptive tool of inequality-producing processes and employment relations in the labour market, examining underlying job characteristics directly is a promising avenue for future research in understanding over time dynamics in the evolution of occupational inequalities.