Social inequalities in ill‐health: the significance of occupational status, education and income‐results from a Norwegian survey

Abstract

The aim of the paper is to examine the interrelationships between socioeconomic indicators such as occupational status, education and income, and self‐reported ill‐health in a nationwide, representative sample of employed Norwegians aged 20–64 years. Three measures of ill‐health were selected for scrutiny: long‐standing somatic illness, reduced work potential due to longstanding somatic illness, and symptoms of nervous conditions. The relationships between the health outcomes and the socioeconomic variables were modelled by means of logistic regression while controlling for age, sex, marital status, and area of residence. The analyses show that occupational status stands out as the most important and most consistent predictor of ill‐ health, as it was significantly related to all three health outcomes. The pattern which appeared was a familiar one; the experience of ill‐health was more common among people in low status occupations, e.g. unskilled workers, compared with people in high status occupations, e.g. higher salaried employees. Education, on the other hand, was not significantly related to any of the three measures of ill‐health when other variables were controlled for. Disposable household income had an independent effect on longstanding somatic illness and symptoms of nervous conditions, while personal gross income had an independent effect on reduced work potential due to longstanding somatic illness. Personal income and occupational status also interacted with respect to work potential: Among unskilled workers, lower salaried employees, and ‘other’ self‐employed the odds ratios of experiencing reduced work potential increased with increasing income, while for the other occupational groups the trend was the opposite. In a closing section, possible interpretations of these patterns are discussed. Copyright © 1994, Wiley Blackwell. All rights reserved