Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

Abstract

BackgroundThe aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wright’s social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea.MethodsThis study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19–64 years. Subjects were classified into twelve social class positions based on the Wright’s social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models.ResultsNonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men.ConclusionsWe showed the inequality in self-rated health according to the Wright’s social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4269-9) contains supplementary material, which is available to authorized users.

Neo‐Marxian social class inequalities in oral health among the South Korean population

“…Finally, 10 groups of class positions were able to be used in this study: capitalists, small employers, the petty bourgeoisie, managers, expert supervisors, skilled supervisors, nonskilled supervisors, expert workers, skilled workers and nonskilled workers. The expert managers and the skilled managers were combined into the managers group due to the small number of individuals, along with no persons being in the nonskilled managers group …”

“…Explaining the roles of mediating factors between SEP and oral health conditions will have important meaning for both policy and implementation. The most frequently used SEP indicators have been education, occupation and income, while relatively few studies have introduced the social class based on Neo‐Marxist theory to explain health inequalities …”

“…Only one study using the NMSC related to health could be found for Koreans so far . To our knowledge, none of the found studies has used the NMSC to describe, examine, or explain the inequalities of oral health.…”

“…The most frequently used SEP indicators have been education, occupation and income, while relatively few studies have introduced the social class based on Neo-Marxist theory to explain health inequalities. [4][5][6] Only one study using the NMSC related to health could be found for Koreans so far. 6 To our knowledge, none of the found studies has used the NMSC to describe, examine, or explain the inequalities of oral health.…”

“…[4][5][6] Only one study using the NMSC related to health could be found for Koreans so far. 6 To our knowledge, none of the found studies has used the NMSC to describe, examine, or explain the inequalities of oral health. In the research on oral health and social inequality mentioned above, none of them used the NMSC.…”