The associations of social class and social stratification with patterns of general and mental health in a Spanish population

Background. Social class, as a theoretical framework, represents a complementary approach to social stratification by introducing social relations of ownership and control over productive assets to the analysis of inequalities in economic, political, and cultural resources. In this study we examined whether measures of social class were able to explain and predict self-reported general and mental health over and above measures of social stratification. Methods. We tested this using the Barcelona Health Interview Survey, a cross-sectional survey of 10 000 residents of the city's non-institutionalized population in 2000. We used Erik Olin Wright's indicators of social class position, based on ownership and control over productive assets. As measures of social stratification we used the Spanish version of the British Registrar General (BRG) classification, and education. Health-related variables included self-perceived health and mental health as measured by Goldberg's questionnaire. Results. Among men, high level managers and supervisors reported better health than all other classes, including small business owners. Low-level supervisors reported worse mental health than high-level managers and non-managerial workers, giving support to Wright's contradictory class location hypothesis with regard to mental health. Social class indicators were less useful correlates of health and mental health among women. Conclusions. Our findings highlight the potential health consequences of social class positions defined by power relations within the labour process. They also confirm that social class taps into parts of the social variation in health that are not captured by conventional measures of social stratification and education.