Social Class Inequality in Mortality From 1921 to 1972 in England and Wales

Abstract In this paper the data on occupational and social class mortality published decennially for England and Wales are used to examine the trend in the size of class differentials in mortality from 1921 to 1972 for adult men, married women and infants. Using summary measures which take into account changes in the relative sizes of the social classes over time, it was found that absolute inequality in mortality increased among adult men and married women during the 1950s and 1960s and relative inequality increased for all three groups. Two widely recognized potential sources of error, changes in the occupational composition of the social classes over time, and discrepancies between the numerators and denominators of occupation-specific death rates are examined to determine their effect on the trend indicated, and the initial findings are confirmed. Finally, the possible causes and implications of rising inequality coincident with declining overall levels of mortality, relative affluence, and the uniform availability of basic medical services to all socio-economic sub-groups of the population are considered.