By definition, the term ‘socio-economic class’ is recognised as ‘Any measure which attempts to classify individuals, families or households in terms of indicators such as occupation , income and education….’ (The Oxford Dictionary of Sociology, 2009), Giddens (2008) indicates that class can be defined by grouping people who share common economic resources that will influence the type of lifestyle that they lead.
The first system of categorising the British public according to socio-economic class was introduced by the Registrar General in 1911 having been created using data collected during from the National Census of that year. It served to categorise the British public into six social groups based upon the occupation of the head of the household, this system remained in place (undergoing modification in 1921 and 1980) until the National Census of 2001 when it was modernised. The new modern system, The National Statistics Socio-economic Classification consisted of eight social groups.
This new system takes into account the ever-evolving middle classes and recognises members of societies employed in professions such as Nursing and The Armed forces as well as the long-term unemployed and students, groups of society which were previously not classified on the scale (Walsh, 2004). It also ceases to recognise the head of the household as solely the man of the house, paying more attention to the fact that women are, in many households the main breadwinner. Any classification system will always have its problems. The situation when someone from a lower social class marries into a family of a higher class or vice versa could influence statistics. Another significant issue could be that a person may perceive himself or herself to be of a different social class than the guidelines categorise them.
In conjunction with the modification of the social classification system in 1980 was the publication of The Black Report (The Department of Health and Social Security, 1980). The outcome of the Black Report was to highlight that while health care in the United Kingdom had considerably improved over recent years, disparity in the classes was still alarmingly evident. Using the Registrar General’s five-category system of social stratification, Black analysed statistics and health records from members of all social classes. This was in an attempt to pinpoint why these divides in the health of the nation were evident. The report showed that with the exclusion of death from skin cancer, members of social class V experienced poorer health than those in the higher social classes and were far more likely to fall victim to illnesses such as heart diseases, cancers and stroke (Denny and Earle 2008). The Black Report found alarming differences in mortality rates of the different social classes in almost all instances (see appendix III). Walsh (2004) drew attention to the fact that although it was exposed that in 1930 that an unskilled worker was 23% more likely to die prematurely than a professional worker, by 1970 this figure had risen to 61%.
Having gathered and assessed this data, the Black Report went on to discuss the reasoning behind its findings. One of the conclusions was that the report’s findings regarding a person’s potential health was due to an ‘artefact explanation’. The term artefact, by definition describes something that is manmade; this could imply that the findings of the report were influenced by the type of questions asked by researchers as well as the way that the information was collated. It could be suggested that the research was manipulated in order to provide a particular result (Birchenall and Birchenall, 2000). Walsh (2004) went on to state that the data collected is selectively sought in order to provide sociologists with desired statistics and is therefore not an accurate indication of a link between socio-economic class and health.
Social selection was deemed another possible cause for the findings in the report. This implied that a person in a higher social class was healthier and fitter, therefore more able to work and thus progress up the social class ladder (Harlambos and Holborn 2004). ‘It is all part of a natural pattern whereby the least able occupy the least demanding and rewarding jobs.’ Denny and Earlle 2008 (p148). The differences of a cultural/behavioural nature between the classes were also considered to play a part in the findings of the report. The data collected showed that people in the lower classes were more likely to smoke, drink excess alcohol and take to little exercise compared to those in the higher socio-economic classes. This would consequently have a detrimental effect upon their health and morbidity (Walsh, 2004). These lifestyle choices may be seen as a direct decision by the lower classes as choice what a person eats and drinks is freely made. However, it is apparent that a healthy diet consisting of fresh nutritious ingredients is more expensive and therefore less obtainable to someone on a lower income than a diet rich in saturated fats and processed ingredients (Giddens, 2008).
The material differences between the classes were also perceived to influence the divide in health. Low income, poor housing and poor working conditions as well as high levels of unemployment are also acknowledged as a contributory factor to poor health (Denny and Earle 2008). Walsh (2004) went on to specify that members of the lower social classes who do suffer the effects of low income and poverty are in fact casualties of inequalities within the structure of society, they are not guilty of poor decision making.
More recently, we have seen the publication of the Acheson report, fully titled ‘The Independent Inquiry into Inequalities in Health Report ‘. This report, commissioned by the Labour government in 1997 again served to underline the disproportions in health between the socio-economic classes (Giddens, 2008). Chaired by Sir Donald Acheson, the report focused upon the most recent data available from the both the Office of National Statistics and the Department of Health. Denny and Earlle (2008) maintained that while the Acheson report did highlight the fact that over the past five decades the average mortality rate in the UK had fallen, the long-standing inequalities within the socio-economic classes have in some cases widened. Using the Registrar Generals classification system the Acheson report emphasized that during a period of time since the publication of the Black Report, from 1970 until 1992, the gap in mortality rates between the socio-economic classes was still considerable (see appendix IV and V). Emphasized within the report are the significant gaps between social class I and V in the numbers of people dying from diseases such as lung cancer, coronary heart disease and stroke.
Similar to the Black Report, there are several considered arguments for these results. Primarily, these diseases are frequently regarded as a social consequence as they can occur because of a particular lifestyle choice. For example, the main cause of lung cancer is widely recognised as smoking. ‘Socio-economic inequalities in smoking: an examination of generational trends in Great Britain’, a report by the Office for National Statistics underlines the fact that smoking is a habit commonly associated with those in the lower social classes. Appendix VI shows that although over recent years that although the number of people smoking as a whole has dropped, those who continue to smoke are predominantly in the lower, unskilled socio-economic classes. Factors contributing to a high instance of coronary heart disease and strokes among the lower social classes may be diet. Walsh and Crumbie (2007) state that obesity poses severe risks to health, it may also lead to an increased chance of suffering from coronary heart disease in both males and females. Statistics provided by the Department of Health show that there are in fact over twice as many obese females in social class V as there are in social class I (see appendix VII). This data could be viewed as an artefact result. Again, using the Register Generals system for social stratification as an example (see appendix VIII), we can see from the pyramid system illustrates, the number of people in social class I is hugely outweighed by the number of people who are members of social class V. Therefore, the results obtained are both predictable and to be expected.
The effect of socio-economic class upon the health of children in the UK is another widely publicised issue within our society. Data published in ‘Health Report Quarterly’, a quarterly publication by the Office of National Statistics demonstrates that there are higher instances of childhood illness and morbidity within families that with unskilled and manual occupations, regardless of marital status (see appendix III and IX). Payne (2006) also stated that despite differing methods of data collection, the findings within this report are dictated by the parent’s socio-economic class. It was also recognised that factors such as low birth weight follow the same pattern. Unfortunately, research has shown that a child’s socio-economic status at birth will have a marked effect upon their future life chances. The Child Poverty Action Group (CPAG), an organisation devoted to raising awareness of the issues that children living in poverty face, reported that data collected in 2006/07 there were as many as 2.9 million children living in poverty in this country. The government has set a target to lower this number to 1.7 million by 2010/11. Whether this figure will be achieved remains to be seen. The CPAG gas also indicated that ‘Children born into social class V are five times more likely to die in an accident and fifteen times more likely to die in a fire than children in social class I’ (Poverty: The Facts 2004).
The concluding subdivision of the Acheson report laid down thirty-nine recommendations that to be followed in an attempt to rectify this situation. These recommendations covered a variety of subjects including the health of families, poverty, income tax and benefits and the National Health Service. Within these guidelines, particular attention has been to decreasing the gap in health care for young children and the elderly, expectant mothers as well as women of a childbearing age. Improvements to housing and education in Britain are also set to become priority. Donald Acheson saw a solution to this problem in treating the causes of the divide amongst the health of the classes, not just the symptoms.