Social Perspective: The Missing Element in Mental Health Practice by Richard U'Ren

Author:Richard U'Ren [U'Ren, Richard]
Language: eng
Format: azw3
Publisher: University of Toronto Press
Published: 2011-09-10T04:00:00+00:00

Early Social Class Influences

Socioeconomic position at all ages strongly defines the social contexts to which individuals are exposed (Turner & Avison, 2003), and the influence of socioeconomic position begins before birth. White women who are poor, for example, have a higher chance of giving birth to a low weight baby than those who are not (Power & Matthews, 1997; Wood, 2003). Low birth weight or a diminished growth rate during the first year of life, presumably the result of adverse intrauterine influences, increases the risk for hypertension, diabetes, and cardiovascular disease in later life (Barker, 1998).

One of the most persuasive pieces of evidence that socioeconomic position at birth is related to risk factors for health and well-being in later life is the British birth cohort study of 1958 (Power et al., 1997; Power & Matthews, 1997).

The study included all children – 17,414 – born in the United Kingdom during one week in March 1958. Follow-up surveys were conducted when they were seven, eleven, sixteen, twenty-three, and thirty-three years old, at which time there were still 11,404 (65%) of the participants in the study. They were categorized at birth on the basis of their father’s occupation (a marker of social class) into six groups, of which the top and bottom two were combined. Thus the final four groups were classes I and II (professional and intermediate), III-nm (skilled, non-manual), III-m (skilled manual), and classes IV and V (semi-skilled and unskilled manual workers). When they reached the age of thirty-three, they were asked to rate themselves on fifteen measures of health. Among these ratings were items related to overall health and current level of psychological distress.

Psychological distress and risk factors for poor health at thirty-three were associated with social class at birth. The prevalence of both showed a clear gradient: distress and health risk factors increased incrementally as paternal socioeconomic position declined. Hay fever was the only condition that showed a higher prevalence in the more privileged group. Many other personal and environmental characteristics were associated with class position at birth also, as shown in table 6.1. Thus, in addition to health status and psychological distress at age thirty-three, economic circumstances, health-related behaviours, social and family functioning, marriage, educational achievement, and job status were all significantly correlated with social class of origin. Strongly linked to later distress were poorer economic circumstances during early life, less social support, less education, less secure employment, and more job stress once the work force had been entered. Power and Matthews (1997) comment:

Table 6.1 Characteristics of British Birth Cohort study sample associated with social class of origin

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