Alonso J, Pérez P, Sáez M, Murillo C
Unitat de Recerca en Serveis Sanitaris, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona.
Gac Sanit. 1997 Sep-Oct;11(5):205-13. doi: 10.1016/s0213-9111(97)71299-8.
Measuring social class is important for evaluating its influence on health status and on the access to health services. This paper is aimed to assess the construct validity of the classification of social class based on the individual's occupation.
Data come from the Barcelona Health Interview Survey of 1986. In the survey, 2,205 households and 6,894 individuals participated (82% of the eligible households and 84% of the eligible individuals). Information was gathered on, among other issues, the following socioeconomic variables: annual family income, lack of some household services, property of the household, education level and occupation of the individuals, as well as their occupational situation and labor relationship. Data about the value of the household was collected from the City Council census (catastro). Social class was assigned using the individual's occupation or, if none, the head of the household's occupation in the following groups: I, II, III, IVa, IVb, V, and "Not Classified". The association between social class and socioeconomic variables was analyzed using: ANOVA for the comparisons of continuous variables, Chi-squared test for categorical variables, Spearman correlation coefficients and discriminant analysis.
A total of 3,357 individuals reported an occupation. "Employed in administrative services" was the most common (14.3%). Social class was "Not classified" in 6.4% of the individuals. All socio-economic variables showed statistically significant differences, following a predicted pattern: better indicators for more favoured social classes. Social class showed a moderate to high correlation with education level (r = 0.57) and somewhat lower with the other variables. Variance in socioeconomic variables explained by social class was higher than the 95% (p < 0.001).
The pattern of relationships between socio-economics variables was intense, monotone and consistent, suggesting that the occupation is a valid and feasible of social class. Routinely including occupation in health information systems should allow to monitor inequalities in health in Spain.
衡量社会阶层对于评估其对健康状况及获得医疗服务的影响至关重要。本文旨在评估基于个人职业的社会阶层分类的结构效度。
数据来自1986年巴塞罗那健康访谈调查。在该调查中,有2205户家庭和6894人参与(占符合条件家庭的82%,符合条件个人的84%)。除其他问题外,还收集了以下社会经济变量的信息:家庭年收入、缺乏某些家庭服务情况、家庭财产、个人的教育水平和职业,以及他们的职业状况和劳动关系。家庭价值数据从市议会人口普查(地籍)中收集。社会阶层按照个人职业进行划分,若个人无职业,则按照户主职业划分为以下几组:I、II、III、IVa、IVb、V和“未分类”。使用以下方法分析社会阶层与社会经济变量之间的关联:对连续变量进行比较采用方差分析,对分类变量采用卡方检验,采用斯皮尔曼相关系数和判别分析。
共有3357人报告了职业。“从事行政服务工作”最为常见(14.3%)。6.4%的人社会阶层为“未分类”。所有社会经济变量均显示出具有统计学意义的差异,且符合预期模式:社会阶层越优越,指标越好。社会阶层与教育水平呈现中度到高度的相关性(r = 0.57),与其他变量的相关性略低。社会阶层对社会经济变量方差的解释高于95%(p < 0.001)。
社会经济变量之间的关系模式强烈、单调且一致,表明职业是社会阶层的有效且可行的划分依据。在健康信息系统中常规纳入职业信息应有助于监测西班牙的健康不平等情况。