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Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

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Issue Date
2017-04-20
Publisher
BimMed Central
Citation
BMC Public Health, 17(1):345
Keywords
Social classNeo-MarxistSelf-rated healthInequality in healthMediating factors
Abstract
Background
The aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wrights social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea.

Methods
This study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19–64 years. Subjects were classified into twelve social class positions based on the Wrights social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models.

Results
Nonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men.

Conclusions
We showed the inequality in self-rated health according to the Wrights social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health.
Language
English
URI
https://doi.org/10.1186/s12889-017-4269-9

https://hdl.handle.net/10371/117010
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College of Medicine/School of Medicine (의과대학/대학원)Health Policy and Management (의료관리학전공)Journal Papers (저널논문_의료관리학전공)
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