1 Psychology and human development1.10 Social psychology
1.10.4.1 Social class and socio economic status
2 min read
Written by Resident Doctor Committee · Published
Class and socio-economic status
Social class describes a person's relation to employment and ownership, while socio-economic status grades advantage by income, education and occupation.
The Registrar General's (Office of Population Censuses and Surveys) scheme ranks people into five classes by occupation. A newer classification based on employment relations has replaced it, but classic studies still use it.
Class | Description | Examples |
|---|---|---|
I | Professional | Doctors, lawyers |
II | Managerial and technical | Teachers, nurses, middle managers |
IIIN | Skilled non-manual | Clerks |
IIIM | Skilled manual | Electricians, plumbers |
IV | Semi-skilled (partly skilled): routine work needing brief specific training | Machine operatives, care assistants |
V | Unskilled: work needing essentially no training | Labourers, cleaners |
Measuring area deprivation
The Jarman index (Underprivileged Area score) measures area deprivation from census variables, each weighted by general practitioners' judgement of the workload it adds.
Its items include elderly people living alone, children under five, lone parents, recent movers, unemployment and overcrowding.
Area indices share one main limitation: most residents of a deprived area are not themselves deprived.
Class and mental illness
Schizophrenia shows the most consistent excess in lower socio-economic groups, explained by both social causation and social drift.
The gradient also appears for depression, substance dependence and suicide, but is less consistent for bipolar disorder.
Anorexia nervosa is linked with higher social class in treatment-seeking samples, but this largely reflects selection into care and weakens in community samples.
Social causation and social drift
Feature | Social causation | Social drift (selection) |
|---|---|---|
Direction | Disadvantage causes illness | Illness causes loss of status |
Fits best | Common disorders, substance use | Early-onset severe illness |
The social drift hypothesis holds that severe mental illness interrupts education and work, causing downward social and geographical movement, so illness comes first and loss of status second.
Comparing a patient's attained position with their parents' helps separate the two processes; in schizophrenia, causation and drift coexist.
Access to care
The inverse care law (Tudor Hart) is that good care is least available to the populations that need it most, a mismatch of provision against need.
Goddard and Smith divide barriers to access into two kinds, which can interact: an inaccessible clinic compounds a lack of transport.
Barrier | What it covers | Examples |
|---|---|---|
Supply side | How services are organised, staffed and funded; the service could change it | Clinic location, waiting times, appointment hours, referral thresholds |
Demand side | The patient's beliefs, attitudes, knowledge and willingness to seek help | Illness beliefs, stigma, language, transport costs |
Social capital
Social capital is a collective property of social relationships: the networks, shared norms of reciprocity and trust within a community that make cooperation for mutual benefit easier.
It differs from social support, which belongs to the individual.
Component | What it covers |
|---|---|
Cognitive | Trust, values and norms held in people's minds |
Structural | Observable networks, membership, roles, rules, precedents and procedures |