Does survey non-response bias the association between occupational social class and health?

AIMS

A non-response rate of 20-40%is typical in questionnaire studies. The authors evaluate non-response bias and its impact on analyses of social class inequalities in health.

METHODS

Set in the context of a health survey carried out among the employees of the City of Helsinki (non-response 33%) in 2000-02. Survey response and non-response records were linked with a personnel register to provide information on occupational social class and long sickness absence spells as an indicator of health status.

RESULTS

Women and employees in higher occupational social classes were more likely to respond. Non-respondents had about 20-30% higher sickness absence rates. Relative social class differences in sickness absence in the total population were similar to those among either respondents or non-respondents.

CONCLUSIONS

In working populations survey non-response does not seriously bias analyses of social class inequalities in sickness absence and possibly health inequalities more generally.