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A class of origin: The school class as a social context and health disparities in a life-course perspective
Stockholm University, Faculty of Social Sciences, Department of Sociology.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of the present thesis is to examine various aspects of the school-class structure and their links to health in a life-course perspective. The empirical studies are based on two longitudinal data materials of cohorts born in the 1950s, followed up until middle age.

In the first study, the overall status distribution in the school class was shown to be associated with both minor psychiatric disorder in childhood and self-rated health in adulthood. Thus, ill-health was more common among individuals who attended school classes less equal in terms of status.

The second study demonstrated that it was more common among those who had fewer mutual friendships in the school class to report poorer health as adults. Socioeconomic career emerged as the primary explanation for men while, for women, these findings were largely unaccounted for by any of the included child and adult circumstances.

Findings from the third study suggested the child’s status position in the school class, i.e. peer status, to be related to a wide range of health outcomes in adulthood. In particular, lower peer status was linked to an excess risk of mental and behavioural disorders, cardiovascular diseases and diabetes. Childhood social class did not confound these associations to any large extent.

The fourth study examined two types of social isolation in the school class: marginalisation (low peer status) and friendlessness. Hospitalisation due to any disease was more common among marginalised children compared to among non-isolates, whereas no corresponding association was found for the friendless. For both types of isolates, the number of hospitalisations was greater than among non-isolated individuals. Of the studied childhood factors, scholastic ability emerged as an important mechanism.

In sum, this thesis points to the relevance of the school class for health development across the life course and to the complexity of pathways through which influences of the school class may operate.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University , 2011. , 91 p.
Series
Health Equity Studies, ISSN 1651-5390 ; 16
Keyword [en]
Children, School class, Social structure, Social networks, Health inequalities, Longitudinal
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-55628ISBN: 978-91-7447-246-2OAI: oai:DiVA.org:su-55628DiVA: diva2:405731
Public defence
2011-05-20, hörsal 4, hus B, Universitetsvägen 10 B, Stockholm, 13:00 (English)
Opponent
Supervisors
Note
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Submitted. Paper 2: Accepted. Available from: 2011-04-28 Created: 2011-03-23 Last updated: 2011-04-08Bibliographically approved
List of papers
1. The school class as a social network and contextual effects on childhood and adult health: Findings from the Aberdeen Children of the 1950s Cohort study
Open this publication in new window or tab >>The school class as a social network and contextual effects on childhood and adult health: Findings from the Aberdeen Children of the 1950s Cohort study
2011 (English)In: Social Networks, ISSN 0378-8733, Vol. 33, no 4, 281-291 p.Article in journal (Refereed) Published
Abstract [en]

Little is known about the health consequences of the school class as a social network. The present study asked whether overall school-class structure has contextual effects on psychiatric problems in childhood and adult self-rated health. From longitudinal data on a Scottish cohort, measures of school-class structure (centralisation, degree of reciprocity and proportion of isolates) were constructed based on sociometric information. Multilevel analysis demonstrated significant effects of centralisation on both health outcomes. It is suggested that highly centralised classes are characterised by inequality, resulting in a low level of integration, with subsequent negative consequences for health.

Keyword
Social networks, School class, Sociometry, Life course, Birth cohort, Health
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-55627 (URN)10.1016/j.socnet.2011.08.004 (DOI)000298122200004 ()
Available from: 2011-03-23 Created: 2011-03-23 Last updated: 2012-01-29Bibliographically approved
2. Childhood friendships and adult health: Findings from the Aberdeen Children of the 1950s Cohort study
Open this publication in new window or tab >>Childhood friendships and adult health: Findings from the Aberdeen Children of the 1950s Cohort study
2012 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no 3, 378-383 p.Article in journal (Refereed) Published
Abstract [en]

Social relations are known to influence morbidity and mortality but few have studied this association from a life-course perspective specifically targeting the importance of social relations in childhood for adult health. In childhood, a key aspect of children’s relationships is the number of friendships a child has in the school class, i.e. friendship quantity. The overall aim of this study was to examine the association between childhood friendships and adult self-rated health. Data from a longitudinal study of children born in Aberdeen, Scotland, between 1950 and 1956 was used. Information on friendship quantity (1964) was derived from sociometric nominations among classmates and defined as mutual choices. The health outcome was based on self-ratings derived from a questionnaire in 2001-2003. The study included various childhood and adult circumstances as possible explanatory factors. The analysis was based on ordinal logistic regression, producing odds ratios (n=5,814). The results demonstrated a gradient in women’s self-rated health according to the number of friendships in the school class. A number of circumstances in childhood and adulthood were partial explanations. For men, only those without friends reported poorer self-rated health in adulthood. This finding was explained by adult socioeconomic status. It is concluded that childhood friendships are linked to health disparities in middle age, underlining the importance of such relationships and the need for a life-course perspective on health that integrates a variety of mechanisms as they interact across life.

Keyword
Social relations, Childhood, Self-rated health, Birth cohort, Longitudinal
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-55626 (URN)10.1093/eurpub/ckr045 (DOI)000304529400018 ()
Available from: 2011-03-23 Created: 2011-03-23 Last updated: 2012-10-12Bibliographically approved
3. Peer status in school and adult disease risk: A 30-year follow-up study of disease-specific morbidity in a Stockholm cohort
Open this publication in new window or tab >>Peer status in school and adult disease risk: A 30-year follow-up study of disease-specific morbidity in a Stockholm cohort
2009 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 63, no 12, 1028-1034 p.Article in journal (Refereed) Published
Abstract [en]

Background: Children have a social status position of their own, apart from that of the family, that may have an impact on short-term and long-term health. The aim of the present study was to analyse the associations between childhood social status in school (ie, peer status) and disease-specific morbidity in adulthood.

Methods: Data were derived from a longitudinal study using a 1953 cohort born in Stockholm, Sweden: The Stockholm Birth Cohort Study (1953–2003). Peer status was sociometrically assessed in sixth grade (1966). Hazard ratios for adult disease-specific morbidity based on information on inpatient care (1973–2003) were calculated by peer status category for men and women separately, using Cox regression.

Results: The results indicate that the lower the childhood peer status, the higher the overall adult disease risk. There were, however, differences in the degree and magnitude to which disease-specific inpatient care varied with peer status. Some of the steepest gradients were found for mental and behavioural disorders (eg, alcohol abuse and drug dependence), external causes (eg, suicide) and various lifestyle-related diseases (eg, ischaemic heart disease and diabetes). The results were not explained by childhood social class.

Conclusion: The present study underlines the importance of recognising children’s social position, apart from that of their family, for later health. Not only psychologically related diseases but also those related to behavioural risk factors demonstrate some of the largest relative differences by peer status, suggesting that health-related behaviour may be one important mechanism in the association between peer status and morbidity.

National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-28361 (URN)10.1136/jech.2009.088377 (DOI)000271944700015 ()
Available from: 2009-06-15 Created: 2009-06-15 Last updated: 2011-03-24Bibliographically approved
4. Social isolation in the classroom and adult health:  A longitudinal study of a 1953 cohort
Open this publication in new window or tab >>Social isolation in the classroom and adult health:  A longitudinal study of a 1953 cohort
2011 (English)In: Advances in Life Course Research, ISSN 1569-4909, Vol. 16, no 1, 1-12 p.Article in journal (Refereed) Published
Abstract [en]

Empirical evidence of long-term health effects of social isolation in young people is limited. In childhood, the school class emerges as a central context, wherein social disadvantages may be detrimental for health development. The purpose of this study was to examine social isolation in the school class and its association with adult disease. Data was derived from a longitudinal study using a 1953 cohort born in Stockholm, Sweden (n = 14,294). Two types of social isolation in the classroom, friendlessness and marginalisation, were sociometrically assessed in 6th grade (1966). Information on adult health was gathered through registry-data on in-patient care (1973–2003). Analyses were based on logistic regression and Poisson regression. The results demonstrated that both types of social isolation in the school class were related to various adverse individual, school-related and family-related aspects. Moreover, while marginalisation was associated with the odds of becoming hospitalised, friendlessness was not. However, if ever being hospitalised, both types of isolates had significantly more hospital care events. These results were largely unexplained by the included individual, school-related and family-related aspects.

Keyword
Social isolation, School class, Life course, Birth cohort, In-patient care, Health
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-47082 (URN)10.1016/j.alcr.2010.11.001 (DOI)000289128800001 ()
Available from: 2010-11-29 Created: 2010-11-29 Last updated: 2012-01-24Bibliographically approved

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