A class of origin : The school class as a social context and health disparities in a life-course perspective

The aim of the present thesis is to examine various aspects of the school-class structure and their links to health in a life-course perspective. The empirical studies are based on two longitudinal data materials of cohorts born in the 1950s, followed up until middle age. In the first study, the overall status distribution in the school class was shown to be associated with both minor psychiatric disorder in childhood and self-rated health in adulthood. Thus, ill-health was more common among individuals who attended school classes less equal in terms of status. The second study demonstrated that it was more common among those who had fewer mutual friendships in the school class to report poorer health as adults. Socioeconomic career emerged as the primary explanation for men while, for women, these findings were largely unaccounted for by any of the included child and adult circumstances. Findings from the third study suggested the child’s status position in the school class, i.e. peer status, to be related to a wide range of health outcomes in adulthood. In particular, lower peer status was linked to an excess risk of mental and behavioural disorders, cardiovascular diseases and diabetes. Childhood social class did not confound these associations to any large extent. The fourth study examined two types of social isolation in the school class: marginalisation (low peer status) and friendlessness. Hospitalisation due to any disease was more common among marginalised children compared to among non-isolates, whereas no corresponding association was found for the friendless. For both types of isolates, the number of hospitalisations was greater than among non-isolated individuals. Of the studied childhood factors, scholastic ability emerged as an important mechanism. In sum, this thesis points to the relevance of the school class for health development across the life course and to the complexity of pathways through which influences of the school class may operate.
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Submitted. Paper 2: Accepted.