Chapter 1: What is social inequality?
Because of different measures of social inequalities it is difficult to make comparisons between
nations and to look at trends over time. Confusion about how to measure social inequality (often seen
as social position) has implications for the study of health inequality.
Social inequality
o Often measured as high or low income, social class, status
o But it is problematic as different people attach different meanings to low and high
status or income
o SEP (socio-economic position)
Krieger and colleagues in 1997 used the term social position to encompass class and status and ‘socio-
economic position (SEP)’ to include income or wealth differences. It is a step forward but not perfect.
To illustrate: income and wealth are not really types of ‘position’ in society while income can be
regarded this way.
Example: two people with the same income may be in different socio-economic positions in
terms of their status, income or class relative tot heir friends, workmates etc
That’s why Krieger suggested that in research these dimensions of inequality need to be kept separate.
The most suitable measure according to Krieger: depends on the way in which the researcher
thinks social inequality is producing inequalities in a specific health outcome.
Measures of social position
Social position (leaving out wealth and income) can be presented as:
Social class
Social status (prestige)
These dimensions of inequality (social class and social status) may have different effects on health
(disease) outcomes.
Social class
Measures of social class are based on theories of social structure: people choose their measure
according to theory they prefer. The most prominent theories of social structure are based on the
thinking of Marx and Weber. They divide occupations into groups according to typical employment
conditions and employment relationships. These groups are the social classes and no social class is
higher or lower than the other. Both agree on the importance of two things:
1. Ownership of assets: property, factories or firms
That determines whether a person needs to work at all or an owner of business or land
sufficient to make working unnecessary.
2. The relationship of all those who have to work for a living with those who own and manage
the establishments in which they work
The most used definition of social class is based on the work of Weber:
Social class = combining occupations whose members would tend to have similar sources and levels
of income job security and chances of economic advancement, and who would have a similar location
within systems of authority and control within businesses, and hence similar degrees of autonomy. So
social classes are essentially groups of occupations.
The Erikson-Goldthorpe-Portocarrero classification (EGP)
The most basic classificatory division in the schema of social class are:
the owners
, those who are not. Those who own no property or company may either be employees
or self-employed workers.
o Employees have more sub-divisions according to:
the skill needed for their work
manual or non-manual
the nature of their employment contract
service contract = managerial and professional work,
employees with his contract have to be trusted, their work
cannot be supervised by monitoring their time-keeping, in
order to motivate performance employees are offered more
job security, salary increments and progressive career
incentives to good and loyal service
labour contract = employees perform work that is more
easily monitored, payment is closely tied to number of hours
of work and sometimes to how much is produced in that
time, less likelihood of career progression, job security is
lower
The principles behind EGP schema, of employment relations and conditions as the basis for defining
social classes have been further developed into he new class schema: the National Statistics Socio-
economic Classification (NS-SEC). It is now use din official government reports in UK.
Difference between EGP scheme and NS-SEC is that notion of skill and the manual/non-manual
divide have disappeared from the classificatory principles. The criteria for allocating accupations to
different classes are more explicit in the NS-SEC:
the timing of payment of work (monthly versus weekly, daily or hourly)
the presence of regular increments
job security (over or under one month)
how much autonomy the worker has in deciding when to start and leave work
promotion opportunities
degree of influence over planning of work
level of influence over designing their own work tasks
The seven-category version of NS-SEC is most likely to be used (social class):
1. higher managerial and professional occupations: employers in large firms, higher managers
and professionals, whether they are employers or self-employed
2. lower managerial and professional occupations and higher technical occupations
3. intermediate occupations (clerical, administrative, sales workers with no involvement in
general planning or supervision but high levels of job security, some career prospects and
some autonomy over their work)
4. small employers and self-employed workers
5. lower technical occupations (with little responsibility for planning own work), lower
supervisory occupations
6. semi-routine occupations (moderate levels of job security, little career prospects, no pay
increments, some degree of autonomy over their work)
7. routine occupations (low job security, no career prospects, closely supervised routine work)
Social status (prestige)
In everyday life people often use ‘social class’ to refer to what sociologists would call ‘social status’.
Unlike social class, social status involves hierarchical ranking from top to bottom of society.
Social class = essentially groups of occupations
, Social status = differential ranking of respect and ‘social honour’ accorded to persons in society.
Attribute of an individual, derived from their family, religious, tribal or ethnic background and
independent of their occupation.
Caste system in India, Hindu cultures based on occupations of ancestors
Unlike class, the sources of status are specific to historical time and place
Segregations of whites and African Americans in America was there regardless of the
occupations or income of the discriminated group (class)
Two measures of social position in UK which depend on interactions between member sof different
occupations:
1. Cambridge scale – used in the study of health inequality
2. Social status based on degree of friendship between members of different occupational
groups, in this measure, prestige is more based on degree of manuality = people tend to have
friends form among occupational groups with a similar degree of manual or non-manual work
to their own
Socio-economic status in American sociology
In America there is no established hereditary aristocracy and the idea that people who do not need to
work are of higher status is less prevalent. So the status is not due to family, but rather positive
personal characteristics they must have in order to gain access to functionally essential occupation
with privileged employment conditions (as described in the NS-SEC). This is called structural-
functionalism – clear logic for social inequality, it states that people naturally have unequal abilities
and some are more talented. Members of certain occupations, therefore, have higher socio-economic
status. So in America occupation is closely linked to prestige.
There are hundreds of occupations in a society, so it is difficult to rank them all when attempting to
measure status in the US. One way around this was to find out the average income and education level
of the jobs which had been given a score and to use this to transfer the score to other occupations.
Socio-economic status = combined income and education as the sole measure of social position
Great British Class Survey (it should be called position instead of class)
They measured social position that included participation in highbrow or lowbrow leisure
pursuits
This measure gets closer to a person real merits in terms of their intellectual capacities
In functionalist terms it would be a better measure of social position than income or ownership
of assets
Registrar General’s Social Classes (RGSC)
Registrar General was the most commonly used indicator of social inequality in British studies of
health inequality and many studies still use this measure.
The classes are based on ‘general standing in the community’ or ‘occupational skill’
Classification consists of 6 categories:
1. Professional
2. Managerial
3. Clerical, sales
4. Skilled manual
5. Semi-skilled manual
6. Unskilled manual
RGSC schema is not used as a measure of class at all in the sense used by NS-SEC. it is
usually regarded as a hierarchy. There is an assumption that non-manual work is higher than
any manual work
