Social Class, Social Mobility and Risk of Psychiatric Disorder - A Population-Based Longitudinal Study

Sanna Tiikkaja · Sven Sandin · Ninoa Malki · Bitte E Modin · Pär Sparén · Christina M. Hultman

32 citations0/0 files storedPLoS ONE

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Health disparities and outcomes Mental Health Treatment and Access Intergenerational and Educational Inequality Studies

Abstract

OBJECTIVES: This study explored how adult social class and social mobility between parental and own adult social class is related to psychiatric disorder. MATERIAL AND METHODS: In this prospective cohort study, over 1 million employed Swedes born in 1949-1959 were included. Information on parental class (1960) and own mid-life social class (1980 and 1990) was retrieved from the censuses and categorised as High Non-manual, Low Non-manual, High Manual, Low Manual and Self-employed. After identifying adult class, individuals were followed for psychiatric disorder by first admission of schizophrenia, alcoholism and drug dependency, affective psychosis and neurosis or personality disorder (N=24,659) from the Swedish Patient Register. We used Poisson regression analysis to estimate first admission rates of psychiatric disorder per 100,000 person-years and relative risks (RR) by adult social class (treated as a time-varying covariate). The RRs of psychiatric disorder among the Non-manual and Manual classes were also estimated by magnitude of social mobility. RESULTS: The rate of psychiatric disorder was significantly higher among individuals belonging to the Low manual class as compared with the High Non-manual class. Compared to High Non-manual class, the risk for psychiatric disorder ranged from 2.07 (Low Manual class) to 1.38 (Low Non-manual class). Parental class had a minor impact on these estimates. Among the Non-manual and Manual classes, downward mobility was associated with increased risk and upward mobility with decreased risk of psychiatric disorder. In addition, downward mobility was inversely associated with the magnitude of social mobility, independent of parental class. CONCLUSIONS: Independently of parental social class, the risk of psychiatric disorder increases with increased downward social mobility and decreases with increased upward mobility.

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References

2001The world health report 2001 - Mental health: new understanding, new hope 1992Socioeconomic Status and Psychiatric Disorders: The Causation-Selection Issue 2000Social Epidemiology 2004Status Syndrome 2003Widening socioeconomic inequalities in mortality in six Western European countries 1984Social Class of Men, Women and Families 2005The Impact of Childhood and Adult SES on Physical, Mental, and Cognitive Well-Being in Later Life 2004Socioeconomic Position and Major Mental Disorders

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