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Social Science and Medicine
Vol: 59 Issue: 10, November, 2004, pp: 2109-2120

Social inequalities and disability in older men: prospective findings from
the British regional heart study
Shah Ebrahima Olia Papacostab, Goya Wannametheeb, Joy Adamsona

Abstract
The independent association of socio-economic position with self-reported
disability was assessed. The effect of home and car ownership as additional
indices of socio-economic position within occupational social classes was
explored. Data from a prospective study of a cohort of 7735 men aged 40–59
years at recruitment and representative of the occupational social class
distribution of middle-aged men in Great Britain were used. Men were
selected from one general practice in each of 24 towns in England, Wales
and Scotland in 1978–1980. The present study concerns 5773 (88.4% of those
able to take part) men aged 52–73 years at follow up in 1992 who completed
the disability section of a postal questionnaire. A quarter (1453) of men
reported disability. Socio-economic position measured as both occupational
class (social class I vs. V: age-adjusted OR 5.0, 95% CI 3.4–7.5) and
ownership of home and car (both vs. neither: age-adjusted OR 2.8, 95% CI
2.3–3.4) showed a graded relationship with likelihood of report
ing disability in 1992. Within all social class groups, those owning both
home and car had a lower risk of disability than those who owned neither,
even after adjustment for a wide range of risk factors. Men from manual
occupations were more likely than those in non-manual occupations to report
disability on developing chronic diseases. The relationship between
socio-economic position and severe, but not milder, disability appeared to
be independent of disease status. Socio-economic position is a strong
predictor of disability in later life independent of a wide range of
lifestyle factors and presence of diagnosed disease. The likelihood of
reporting disability between and within social class groups is influenced
by material wealth.

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