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Study finds differences between men and women in the effects of social class on behavioral risk factors

A new study of British civil servants explored reasons for the differences in social inequality in cardiovascular disease between men and women by analyzing the associations between their own or their spouses' (or partners') socioeconomic position and a set of risk factors for prevalent chronic diseases. Michael Marmot, M.B.B.S., M.P.H., Ph.D., of the International Centre for Health and Society, and his colleagues measured the socioeconomic position of London civil servants according to their civil service grade and the socioeconomic position of their spouses and partners according to the Registrar General's social class schema. They examined the following cardiovascular risk factors: smoking, diet, exercise, alcohol consumption, and measures of social support.

Wives' social class membership made no difference at all to the likelihood that male participants in the Whitehall II study were smokers or exercised little. In contrast, female participants' level of exercise and smoking status was related to their spouse's social class independently of their own grade of employment. Diet quality was affected equally by the socioeconomic position of both male and female partners. Unlike the behavioral risk factors, the degree of social support reported by women participants generally was not negatively affected if their husband or partner was in a less advantaged social class.

However, non-employment of the husband or partner was associated with relatively lower levels of positive social support and higher negative social support, while men with non-working wives or partners were unaffected. These findings highlight some of the problems encountered in health inequality research. Investigators must pay closer attention to the different processes behind material power and emotional power within the household when investigating male/female differences in health and risk factors. This research was supported in part by the Agency for Healthcare Research and Quality (HS06516).

See "Gender differences in the relationship of partner's social class to behavioural risk factors and social support in the Whitehall II study," by M. Bartley, P. Martikainen, M. Shipley, and Dr. Marmot, in Social Science & Medicine 59, pp. 1925-1936, 2004.

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