Health, Inequality and Social Structure

  • Richard G. Wilkinson
Part of the Studies in Biology, Economy and Society book series (SBES)


Class differences in mortality rates are the most widely used measures of the social distribution of health. Though they have many shortcomings, they are the best data we have. The last comprehensive figures available for England and Wales centre on 1981 and show differences in age-specific death rates between classes I (professional occupations) and V (unskilled manual occupations), which, if applied throughout the lives of a cohort, would produce a difference of more than seven years in life expectancy at birth (OPCS 1978, p. 190). This amounts to a 10 per cent difference in life-expectancy — the equivalent to shortening the unskilled manual worker’s day from 24 to about 21 hours or lopping five weeks off every year. (Because of problems in classifying women by occupational class, I refer to male death rates throughout this paper. The differences between the sexes, while important in other contexts, do not affect the argument put forward here.)


Social Class Income Inequality Sickness Absence Class Difference Income Redistribution 
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© The Eugenics Society 1988

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  • Richard G. Wilkinson

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