The concept of social class has been explored by several sociologists. This essay

will focus on defining social class and demonstrate its relevance to the

understanding of society, social issues and health.

A number of sociologists have attempted to define social class. It is not an easy

concept to describe. Marx and Engels (1848) defined social class as being divided

into ‘The Bourgeoisie’ who owned the land and factories. They exploited the lower

working masses that were termed, ‘The Proletariat’. Marx’s (1848) view was that

social class was linked to the conflict between the two classes. Marx and Engels

(1848) defined social class in relation to the ownership of means of production

Weber (1946), on the other hand, divided social class into power, wealth and

prestige. Social class was based on social order. Power was distributed according to

a set of formal rules. Weber (1946) stated that ‘class’ was based on individuals’

attitudes to others.

Today, social class may be defined in a number of different ways. Firstly, in

economic terms, for example, occupation, income and wealth. Secondly, in political

terms, that is, status and power. Thirdly, in terms of an individual’s culture, for

example, different beliefs, values, thoughts about what is socially acceptable and

educational level. The National Office for Statistics has, since 2001, used the

National Statistics Socio- Economic Classification (NS-SEC) to classify social class

in Britain (fig. 3.) This replaced the Registrar General’s social class (fig.2) which was

based on occupation. The latter was considered to be narrow and misleading

because it did not take into consideration, full time students, the long term

unemployed, those that had never worked, and occupations that were difficult to

place in a class description. One may suggest that the classifications needed

updating. It could be suggested, given the recent reclassification, that social class

may now be thought of in “socio economic group” terms. It must be noted, however,

that these [socio economic] classifications are not the only determinants of life

chances (www.ons.gov.uk). Other drivers may include, genetic inheritance, family

structure, attitudes and aspirations (Aldridge, 2004) (fig 1). The evidence may

suggest that improving individuals’ opportunities in life, rather than their social

mobility, may improve their life outcomes (Independent Commission on Social

Mobility, 2009).

“People with higher socioeconomic position in society have a greater array of life

chances and more opportunities to lead a flourishing life. They also have better

health” (Marmott, 2010). The evidence suggests that social class is linked to

inequality in both society and health. Generally, those of a lower socio economic

group tend to have less well paid employment, and therefore less income and

resources available to them. The middle classes generally exercise more, and have

wider social activities, which may result in a healthier lifestyle. This may be due to a

number of reasons, for example, they may have more disposable income, resulting

in affordability of leisure facilities, holidays, and private health screening. Poorer

socio economic status may result in poorer health, an undesirable lifestyle, and an

increase in morbidity and mortality. It could be suggested that the gap in mortality

between the socio economic groups is getting wider (Taylor & Field, 2003). The

evidence demonstrates that there is a link between social class and average life

expectancy at birth (see the graphs below):

Researchers have identified a class’ pattern’ for certain diseases, which is

influenced from before birth into old age (Lynch & Oelman, 1981; Mitchell,

1984; Townsend, et al.1990 cited in Perry, 1996). This suggests that individuals in

deprived circumstances are more likely to have illness, or to die from chronic

disease, such as heart disease. This may be due in part to poor diet, which may be a

result of social and economic status, rather than through lack of knowledge or

careless food selection (Ellahi, 2009). For example, poorer people may find that

they have barriers to accessing ‘healthy food’ at out- of- town supermarkets because

of, for example, lack of suitable transport (Caraher, M, et al, 1998).Low income

individuals will then have no choice but to buy food that is available to them locally,

which may well be cheaper, but may be also of inferior nutritional content.

Dallison & Lobstein (1995 cited in Purdy & Banks, 1999) suggest that low income

groups tend to cut back on buying food if they have a limited amount of money. This

may result in missed meals and deficiency in essential nutrients.

Certain long term chronic conditions are more prevalent in the lower classes. For

example, men aged 20-64 employed in unskilled manual occupations are around 14

times more likely to die from chronic obstructive pulmonary disease (COPD) than

men employed in professional roles (www.brit-thoratic.org.uk). It could be argued

that the reason for this is that those from poorer socio economic backgrounds are

more likely to smoke than those from higher socio economic groups

(www.cancerresearch.org.uk) . The evidence suggests that smoking may be used

as a coping mechanism to combat stress which may be present in areas of

deprivation (Layte and Whelan, 2009). Smoking may also be seen as socially

acceptable by individuals in these areas ( Shomaimi, et al 2003).

Inferior standards of housing [close to industrialized zones] may well promote high

levels of disease (Farmer, Miller & Lawrenson, 1977). Deprived individuals tend to

live in more deprived neighbourhoods. This may lead to low self esteem, social

isolation and an increase in mental health issues, which may ultimately also affect

physical health. Lack of green space and leisure activities may all contribute to ill

health. Conversely, it could be proposed that persistent mental illness, may result in

middle or upper class individuals being unable to continue working in demanding job

roles, leading to them living in poorer circumstances and this may result in an

increase in susceptibility to illness (Farmer, Miller & Lawrenson, 1977).

The Black Report (Townsend & Davison, 1982) and The Acheson Report

(Acheson, 1998) stated that health inequalities existed. Both reports recommended

that ‘equitable access to effective care should be in relation to need, and this should

occur at every level of The National Health Service’ (Acheson, 1998). In an updated

review, Marmot (2010) stated that ‘dramatic health inequalities are still a dominant

feature of health in England across all regions’. The review recommends that

several issues relating to social inequality are tackled by implementing local

development plans (Marmot, 2010).These issues would help individuals, particularly

in the lower social groups, to improve their life chances and their health. An example

may be by improving public transport in an area of deprivation.

In conclusion, it may be stated that social class is extremely relevant to our

understanding of society, social issues and health. Improving the life chances and

raising expectations for everyone, especially those in low income groups, remains a

challenge, where the ultimate goal is to reach equality and good health for all, no

matter what their social status.

Bibliography

• Acciojellybean. (2009, May 17). AS Sociology Revision #4. Retrieved February 20, 2010, from Youtube: http://www.youtube.com
• Aldridge, S (2004, March 30) Life Chances and Social Mobility- An overview of the evidence retrieved February 25,2010 from www.cabinetoffice.gov.uk
• Acheson, D. (1998). Independent Inquiry into Inequalities in Health Report. London: Crown.
• Babb, P., Martin, J., & Haezdewindt, P. (Eds.). (2004). Focus on Social Inequalities. London: The Stationary Office.
• British Lung Foundation. (2010). Causes and cost of respiratory disease. Retrieved February 20, 2010, from British Lung Foundation: http://www.lung.uk.org
• Cancer Research UK. (2009, December 2). Smoking Statistics. Retrieved February 20, 2010, from Cancer Research UK: http;//www.cancerresearch.org.uk
• Caraher, M., Dixon, P., Lang, T., & Carr- Hill, R. (1998). Barriers to accessing healthy foods: differentials by gender, social class, income and mode of transport. Health Education Journal , 57 (3), 191-201.
• Dallison, J., & Lobstein, T. (1999). Health and Exclusion:policy and provision in health provision (1st ed.). (M. Purdy, & D. Banks, Eds.) London: Routledge.
• Daykin, N., & Jones, M. (2008). Health Studies- An Introduction (2nd ed.). (J. Naidoo, & J. Wills, Eds.) Basingstoke: Palgrave.
• Ellihi, B. (2009). Key Concepts in Public Health (1st ed.). (F. Wilson, & M. Mabhala, Eds.) London: Sage.
• Engels, F., & Marx, K. H. (1848, February 21). The Manifesto of The Communist Party. London: The Communist League.Retrieved February 27,2010 from www.hartford-hwp.com
• Farmer, R., Miller, D., & Lawrenson, R. (1977). Epidemiology and Public Health Medicine (4th ed.). London: Blackwell Science Ltd.
• Graham, H. (2007). A Reader in Promoting Public Health. (J. Douglas, S. Earle, & S. Handsley, Eds.) London: Sage.
• Hardey, M. (1998). The Social Context of Health (1st ed.). Buckingham: Open University Press.
• Hart, N. (1985). The Sociology of Health and Medicine. Ormiskirk: Causeway Press Ltd.
• Health inequalities – extent, causes, and policies to tackle them . (2009, March 15). Retrieved February 20, 2010, from http://www.parliament.uk
• Health inequalities- Social Determinants of Health Film (Glasgow). (2009, December 10).National Social Marketing Centre. Retrieved February 20, 2010, from Youtube: http://www.youtube.com
• Jolley, M., & Perry, A. (1996). Sociology Insights in Healthcare (1st ed.). (A. Perry, Ed.) London: Arnold.
• Jones, R. K., & Jones, P. A. (1975). Sociology in Medicine. London: English University Press.
• Layte, R; Whelan, C.T. (2009). Explaining Social Class Inequalities in Smoking: The Role of Education, Self-Efficacy, and Deprivation. European Sociological Review 2009 25(4):399-410
• Local Planning Information for Liverpool. (2009, November 10) Retrieved 27 February, 2010, from www.liverpool.gov.uk.
• Lynch, P., & Oelman, B. (1981). Mortality in the British Army Compared with the civil population. British Medical Journal , 283, 405-407.
• Marmot, M. (2010). Fair Society, Healthy Lives. London: Crown.
• Mitchell, J. (1984). What is to be done about illness and health? . Harmondsworth: Penguin.
• National Statistics. (2007, October 24). Variations persist in life expectancy by social class- News Release. London: National Statistics.
• Nelson, M. (2000). Childhood nutrtion and poverty. Nutrition Society , 59 (2), 207-315.
• Office for National Statistics ( August 1, 2008) The National Statistics Socio-economic Classification (NS-SEC). Retrieved February 27, 2010 from www.ons.gov.uk
• Purdy, M., & Banks, D. (1999). Health and Exclusion: policy and practice in health provision. London: Routledge.
• Registrar General Social Class (based on Occupation). (n.d.). www.publications.parliament.uk.
• Report from the Independent Commission on Social Mobility (January 2009) retrieved February 27, 2010 from www.docs.google.com
• Shohaimi, S; Luben , R; Wareham,N; Day,N; Bingham, S; Welch, A; Oakes, S; Khaw, K-T (2003). Journal of Epidemiol Community Health.57.270-276
• Taylor, S., & Field, D. (2003). Sociology of Health and Health Care (3rd ed.). Oxford: Blackwell Publishing Ltd.
• The British Thoracic Society. (2006). The Burden of Lung Disease- Second Edition. London: The British Thoracic Society.
• The National Statistics Socio-economic Classification (NS-SEC ( August 1st 2008) retrieved February 21,2010 from Office for National Statistics:www.ons.gov.uk
• Townsend, P., Davidson, N., & Whitehead, M. (1990). The Black Report 1980 and the health divide. Penguin: Harmondsworth.
• Weber, M., Gerth, H. H., & Wright Mills, C. (1946). From Max Weber : Essays in Sociology. New York: Oxford University Press.