University of Sheffield, School of Health and Related Research, Sheffield S1 4DA, UK.
BMJ. 2012 May 9;344:e2316. doi: 10.1136/bmj.e2316.
To see whether adverse relations between social class, health, and economic activity, observed between 1973 and 1993 and previously identified in a 1996 BMJ paper, were still apparent between 1994 and 2009 despite improvements in the general economic climate and overall population health.
Replication of repeated cross sectional analysis from the original paper, using the same source (the General Household Survey) and occupation coding scheme, but extended from the period 1973-93 to 1973-2009, and including women as well as men.
Men and women aged 20-59 years in each annual survey between 1973 and 2009.
Change over time in class specific rates of employment, unemployment, and economic inactivity within subgroups of respondents.
Overall employment rates have decreased for men of working age while increasing for working age women. For men in particular, the gradient of these changes seems to depend on occupational group. Over 37 years, the differences in occupational group specific economic inactivity and employment rates between people reporting and those not reporting a limiting long term illness has increased substantially.
Between 1973 and 2009, the relation between good health and securing and sustaining employment has strengthened for both men and women. For men, this has been due to employment rates decreasing and economic inactivity rates increasing among men with poor health. For women, this has largely been due to a general trend of increased employment and reduced economic inactivity occurring among healthier women but not in women of poorer health. Some evidence suggests that, since 2005, the relation between health, employment, and economic inactivity for women in the top two occupational groups has become more like that for men, with poor health becoming associated with reducing employment rates.
观察 1973 年至 1993 年间以及之前在 1996 年的一篇 BMJ 论文中发现的社会阶层、健康和经济活动之间的不良关系，在整体经济环境和总体人口健康状况改善的情况下，在 1994 年至 2009 年期间是否仍然明显。
重复分析原始论文中的交叉横截面分析，使用相同的来源（家庭综合调查）和职业编码方案，但从 1973-93 年扩展到 1973-2009 年，并包括男性和女性。
1973 年至 2009 年每年调查中年龄在 20-59 岁的男性和女性。
特定阶层的就业、失业和经济不活跃率在不同受访者亚组中的随时间变化。
处于工作年龄的男性整体就业率下降，而处于工作年龄的女性就业率上升。特别是对于男性来说，这些变化的梯度似乎取决于职业群体。37 年来，报告有长期限制疾病和未报告有长期限制疾病的人之间，职业群体特定的经济不活跃和就业率的差异显著增加。
在 1973 年至 2009 年期间，良好的健康状况与确保和维持就业之间的关系对男性和女性都有所加强。对于男性来说，这是由于健康状况不佳的男性的就业率下降和经济不活跃率上升所致。对于女性来说，这主要是由于更健康的女性的就业机会增加和经济不活跃减少的总体趋势，但在健康状况较差的女性中并非如此。有证据表明，自 2005 年以来，女性在头两个职业群体中健康、就业和经济不活跃之间的关系变得更像男性，健康状况不佳与就业率下降有关。
