Class and health in changing societies: the need for novel approaches

Lahelma, Eero; Rahkonen, Ossi

doi:10.1136/jech-2019-213325

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…A Pakistani cross-sectional study has documented good knowledge, positive attitude, and reasonable practices regarding COVID-19 infection inprimary healthcare providers from three tertiary care hospitals [29]. In contrast to our results, a Pakistani study reported low knowledge scores among the general public, including students [30].…”

Section: Plos Onecontrasting

confidence: 99%

Knowledge, attitudes, and practices against the growing threat of COVID-19 among medical students of Pakistan

et al. 2020

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Background On account of the COVID-19 pandemic, many changes have been implicated in university medical students. We are cognizant that pandemic can be controlled with dedicated contributions from all involved in the healthcare profession. Therefore, it is important to know the pandemic and application of knowledge by the medical students to formulate a further line of management in Pakistan. Objective We aimed toinvestigate the knowledge, attitudes, and practices (KAP) regarding COVID-19 and its impact on medical students of Pakistan. Methods A cross-sectional survey was conducted in June 2020 by a validated self—administered questionnaire. The survey instrument was tailored from a published questionnaire comprised of questions on demographics (6), knowledge (14), attitudes (4), and practices (6). Results Of the 1474 medical students in the study, 576(39.1%) were males, and 898(60.1%) were females. Two-thirds of the participants 1057(71.7%) had adequate knowledge, and almost all the students had positive attitudes (1363(92.5%), and good practices 1406(95.4%) to COVID-19. Two-thirds of the medical students 1023(69%) believed that the COVID-19 outbreak had affected their social, mental, and psychological well-being. One-quarter of the medical students 391(26%) become more religious, 597(40%) realized the importance of life, and 1140(77%) became careless because of the pandemic. The female medical students were 2.545 times (p < .001) and 4.414 times (p < .001) more likely to have positive attitudes and good practices toward COVID-19 as compared to males. Conclusion Medical students, especially females and senior year scholars, were well-versed with desired levels of knowledge, attitudes, and preventive measures toward COVID-19. Most of them recognized COVID 19, is shaping their social, mental, and psychological well-being and encroaching on the healthcare system and economy. The information acquired by the KAP study may help to devise effective preventive strategies for future events.

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Section: Plos Onecontrasting

confidence: 99%

Knowledge, attitudes, and practices against the growing threat of COVID-19 among medical students of Pakistan

et al. 2020

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“…Stratificationist (also known as ‘gradational’) measures of social class based on socioeconomic status or position dominate health-disparities research 1–3. For example, many epidemiological analyses have documented that U.S. life expectancy has stagnated or declined for the poor and less-educated and risen for the wealthier and more-educated over the last several decades 4.…”

Section: Introductionmentioning

confidence: 99%

Under capital’s thumb: longitudinal associations between relational social class and health

Eisenberg‐Guyot

Hajat

2020

J Epidemiol Community Health

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BackgroundWe used a relational social-class measure based on property ownership and managerial authority to analyse the longitudinal relationships between class, self-rated health (SRH) and mental illness. To our knowledge, this is the first study using a relational social-class measure to evaluate these relationships longitudinally.MethodsUsing Panel Study of Income Dynamics data from 1984 to 2017, we first assigned respondents aged 25–64 to the not in the labour force (NILF), worker, manager, petit bourgeois (PB) or capitalist classes based on business ownership, managerial authority and employment status. Next, using Cox models, we estimated the confounder-adjusted associations between 2-year-lagged class and incidence of poor/fair SRH and serious mental illness. We also tested whether the associations varied by gender, whether they persisted after more-fully adjusting for traditional socioeconomic-status measures (education and income) and how they changed temporally.ResultsWe identified large inequities in poor/fair SRH. NILFs had the greatest hazard, followed by workers, PBs, managers and capitalists. We also identified large inequities in serious mental illness; NILFs and workers had the greatest hazard, while capitalists had the lowest. Class inequities in both outcomes lessened but remained considerable after confounder and socioeconomic-status adjustment, and we found some evidence that the class–SRH relationship varied by gender, as being NILF was more harmful among men than women. Additionally, class inequities in the outcomes decreased somewhat over time.ConclusionWe identified substantial class inequities in SRH and mental illness. Our findings demonstrate the importance of using relational social-class measures to deepen understanding of health inequities’ root causes.

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“…Socioeconomic health differences can be regarded as a product of the unequal distribution of both material and behavioural health-endangering exposures and health-protective resources between socioeconomic groups acting over the course of life [ 18 , 19 ]. Socioeconomic circumstances cannot thus be fully captured by a single measure, but instead, a multi-domain approach is needed.…”

Section: Introductionmentioning

confidence: 99%

Multiple Socioeconomic Circumstances and Initiation of Cardiovascular Medication among Ageing Employees

Salonsalmi

Mauramo

Lahelma

et al. 2021

IJERPH

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There are persisting socioeconomic differences in cardiovascular diseases, but studies on socioeconomic differences in the initiation of cardiovascular medication are scarce. This study examined the associations between multiple socioeconomic circumstances and cardiovascular medication. The Helsinki Health Study baseline survey (2000–2002) of 40–60-year-old employees was linked with cardiovascular medication data from national registers. The analyses included 5805 employees concerning lipid medication and 4872 employees concerning hypertension medication. Medication purchases were followed for 10 years. The analyses were made using logistic regression, and the odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for childhood, conventional and material socioeconomic circumstances. Low parental education showed an association with lipid medication among women only (OR 1.34, 95% CI 1.11–1.61), whereas childhood economic difficulties showed more widespread associations. Low education and occupational class were associated with an increased risk of both hypertension (education: OR 1.58, 1.32–1.89; occupational class: 1.31, 1.08–1.59) and lipid medication (education: 1.34, 1.12–1.61; occupational class: 1.38, 1.13–1.67). Rented housing (1.35, 1.18–1.54 for hypertension medication; 1.21, 1.05–1.38 for lipid medication) and current economic difficulties (1.59, 1.28–1.98 for hypertension medication; 1.35, 1.07–1.71 for lipid medication) increased the risk. Several measures of socioeconomic circumstances acting at different stages of the life course were associated with cardiovascular medication, with individuals in disadvantageous socioeconomic circumstances having elevated risks.

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Class and health in changing societies: the need for novel approaches

Cited by 4 publications

References 13 publications

Knowledge, attitudes, and practices against the growing threat of COVID-19 among medical students of Pakistan

Knowledge, attitudes, and practices against the growing threat of COVID-19 among medical students of Pakistan

Under capital’s thumb: longitudinal associations between relational social class and health

Multiple Socioeconomic Circumstances and Initiation of Cardiovascular Medication among Ageing Employees

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