The social distribution of illness: is Australia more equal?

The relationship between socioeconomic status and ill health has challenged researchers and health practitioners for many years. This paper outlines the way several basic measures of morbidity are related to occupation, income and education, with brief attention to class gradients in mortality and service utilization. The international literature contains many studies showing an inverse gradient in health by social standing: people who are socially and economically well off typically enjoy good health as well. Data from a recent health survey conducted in New South Wales, Australia do not confirm the British findings when occupational categories are studied, but when other measures of status are substituted for the crude occupation categories, a number of patterns appear. Income is significantly associated with the probability of chronic illness among middle-aged men and women, and among women over 65. The predicted pattern is also evident for recent illness among young men and for consulting among elderly respondents, but these associations are not statistically significant. Except among the elderly, better educated men and women are healthier than those with less education on most morbidity measures. The parallels and discrepancies between these findings from an Australian sample and overseas studies raise important research and policy questions.