The measurement of social class in epidemiology: a systematic review

Author(s)

Tatiana Yonekura

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD)
• Defense date: 2011-06-17

Examining board members

Cassia Baldini Soares; Dina de Almeida Lopes Monteiro da Cruz; Luiz Augusto Facchini

• Advisor: Cassia Baldini Soares

Abstract

The objectives of this study were to describe and analyze the international scientific production dealing with the measurement of social class in epidemiology and the relationship between social class and health disease process. This essay had as theoretical framework the concepts underlying the field of Collective Health that takes social class as one essential analytical category. The study is a theoretical and quantitative systematic review, which follows the methodological recommendations of the Joanna Briggs Institute (JBI). Theoretical search was used to find models of social class and quantitative search was used to evidence the relation between social class and health disease process. Inclusion criteria were: description of a model of social class used in epidemiological studies and case-control and cohort studies that used a model of social class. We selected 16 databases in social sciences, health care and multidisciplinary for literature search, and multiple combinations of key words for the selection of studies. After the development of search strategies for each database, 22.314 studies were found and 5.994 studies were pre-selected and stored in a bibliography manager. After exclusion of 2.377 duplicate and 49 unavailable studies, 1.890 papers were read in full. In relation to theoretical results, 28 papers were included, of which nine were Latin American, four American and 15 European. More than half of the studies were published in the 70\'s and 80\'s. It is possible to identify the main criteria that differentiate the classes and that support the development of the models: the inclusion of variables related to insertion in the production process. In relation to quantitative results, 123 studies were included, of which 108 were cohort studies (87,8%) and 15 case-controls (12,2%). Most studies showed positive associations between social class and health, as well as higher prevalence of health problems among the lower classes. There is a need to measure the concept of classes, considering changes in the contemporary world of work, overcoming the difficulties of this theoretical and methodological reference. Epidemiological studies should consider the use of social class category to identify health inequalities and thus provide answers that actually respond to health needs of the different social classes. (AU)

• FAPESP's process: 08/08884-7 - The operationalization of the concept of social class in epidemiology: a systematic review of scientific literature
• Grantee: Tatiana Yonekura
• Support Opportunities: Scholarships in Brazil - Master