Socio-Economic Status and Illness

the occurrence of ill-health is commonly accepted as a proven fact. The gross differences in prosperity between advanced and under-developed countries are certainly associated with large differences in mortality. Less marked but still appreciable mortality variations have been observed between social classes within countries. That these observations reflect social influences upon the occurrence of ill-health and not merely upon the outcome of disease has been suggested by the results of morbidity investigations made in North America earlier in this century (1, 10). There have, however, been few reappraisals of this question in recent years among economically advanced populations. Among such groups it is quite possible that the smaller variations in socio-economic position which now exist have no appreciable effect upon the occurrence of illness. Graham (3) has described a study of the relation between socio-economic status, illness, and the use of medical services, based upon personal interviews with members of a sample of the general population in Butler County, Pennsylvania, in 1954. He found that there were no significant differences among five occupationally determined classes in their frequency of acute and chronic illness or in their use of medical services. The present paper is a report of an inquiry which, like that of Graham, was prompted by the wish to re-examine the relationships between social class and ill-health which were observed in earlier morbidity studies.