A study of male mortality between 2001 and 2008 for example found that in 2001

A study of male mortality between 2001 and 2008 for

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consistent with this broad-brush summary. A study of male mortality between 2001 and 2008, for example, found that in 2001 the mortality rate of those in routine and manual occupation was 2.0 times that of those in managerial and professional occupations; in 2008 that ratio had risen to 2.3. The authors note that ‘this pattern of declining absolute but rising relative inequalities is a well-known phenomenon in the context of declining overall mortality rates’ (Langford and Johnson 2010: 1). The recent Strategic Review of Health Inequalities (The Marmot Review 2010) affords comprehensive coverage of SECs and health and longevity. It has been suggested that a ‘social gradient’ exists: in other words, relationships between SECs and measures of health and longevity are finely tuned: not only are there dramatic differences between best-off and worst-off in England and Wales, but the higher one’s social position (or for that matter, level of education, occupational status or housing conditions) the better one’s health is likely to be. Muntaner et al . (2010), however, have shown that SECs like NS-SEC that are particularly sensitive to employment relations do not always reveal a graded relationship: small employers can exhibit worse health than highly skilled workers for example, and supervisors can display worse health than frontline workers. 132 Graham Scambler Ó 2011 The Author Sociology of Health & Illness Ó 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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There is a relative paucity of material for developing societies, certainly as far as social gradients are concerned. There is ample evidence nonetheless for ubiquitous inter- and intra- national health inequalities (WHO 2008). Relations other than class and SECs Passing reference has been made to class and SEC-related phenomena like poverty, income, educational qualifications, occupational status and housing tenure, to which might be added neighbourhood amenities, car ownership and so on. None of these phenomena are perfectly correlated with class SECs, each being answerable to other forms of privilege and social division. Gender, ethnic and spatial relations have received most attention with regard to health inequalities in the UK (Graham 2007, 2009, Annendale 2010, Bradby and Nazroo 2010). This is not the occasion to review these distinctive and important fields, none of which reduces to class or SEC; but it is apposite to note both the heterogeneity and what Pease (2010) describes as the ‘normativity’ of privilege. The latter involves processes of ‘othering’, interpreted here as a method of portraying difference as if it were somehow alien from the socially orthodox or that which passes as normal. Table 1 lists a number of statuses that are valued, alongside their more negatively valued counterparts. While investigations of the salience for health inequalities of a number of items on Pease’s list have been fairly comprehensive, others remain neglected. A distinction needs to be drawn too between objective and subjective approaches to status. Marmot (2006), for example, maintains that people’s subjective sense of their social positioning is salient for their health.
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