Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?

• Published in: Social science & medicine (1982) 2004-05, Vol.58 (10), p.1869-1887
• Main Authors: Borrell, Carme, Muntaner, Carles, Benach, Joan, Artazcoz, Lucı́a
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis. Health state; Barcelona, Spain; Biological and medical sciences; Class; Division of labour; Employment - classification; Employment - psychology; Epidemiology; Family Characteristics; Female; Gender; Gender differences; General aspects; Health; Health inequalities; Health Status; Health Surveys; Households; Housekeeping - classification; Housekeeping - statistics & numerical data; Housework; Humans; Inequalities in health; Inequality; Job Satisfaction; Logistic Models; Male; Mediating factors; Medical sciences; Medicine; Men; Middle Aged; Occupational Health; Occupations - classification; Occupations - statistics & numerical data; Ownership; Public health. Hygiene; Public health. Hygiene-occupational medicine; Self Concept; Self-reported-health; Sex Differences; Sex Factors; Social Class; Social classes; Social Inequality; Social sciences; Socioeconomic Factors; Socioeconomic status; Spain; Spain Social class Self-reported-health Working conditions Inequalities in health Mediating factors; Status; Women; Work Environment; Work Organization; Work Schedule Tolerance; Working conditions; Workplace - psychology; Workplace - statistics & numerical data
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(03)00408-8

Social class understood as social relations of ownership and control over productive assets taps into parts of the social variation in health that are not captured by conventional measures of social stratification. The objectives of this study are to analyse the association between self-reported health status and social class and to examine the role of work organisation, material standards and household labour as potential mediating factors in explaining this association. We used the Barcelona Health Interview Survey, a cross-sectional survey of 10,000 residents of the city's non-institutionalised population in 2000. This was a stratified sample, strata being the 10 districts of the city. The present study was conducted on the working population, aged 16–64 years (2345 men and 1874 women). Social class position was measured with Erik Olin Wright's indicators according to ownership and control over productive assets. The dependent variable was self-reported health status. The independent variables were social class, age, psychosocial and physical working conditions, job insecurity, type of labour contract, number of hours worked per week, possession of appliances at home, as well as household labour (number of hours per week, doing the housework alone and having children, elderly or disabled at home). Several hierarchical logistic regression models were performed by adding different blocks of independent variables. Among men the prevalence of poor reported health was higher among small employers and petit bourgeois, supervisors, semi-skilled (adjusted odds ratio—aOR: 4.92; 95% CI: 1.88–12.88) and unskilled workers (aOR: 7.69; 95%CI: 3.01–19.64). Work organisation and household material standards were associated with poor health status with the exception of number of hours worked per week. Work organisation variables were the main explanatory variables of social class inequalities in health, although material standards also contributed. Among women, only unskilled workers had poorer health status than the referent category of manager and skilled supervisors (aOR: 3.25; 95%CI: 1.37–7.74). All indicators of work organisation and household material standards reached statistical significance, excepting the number of hours worked per week. In contrast to men, among women the number of hours per week of household labour was associated with poor health status (aOR: 1.02; 95% CI: 1.01–1.03). Showing a different pattern from men in the full model, household material