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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.
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