Social class: concepts and operationalization models in health research

This article discusses the use of the concept of class in health research, different sociological approaches to social stratification and class structure, and the explanatory potential of the class concept in studies on social determinants and health inequalities. It also elaborates on the operationalization models that have been developed for use in sociological, demographic, or health research, as well as the limitations and scope of these models. Four main operationalization models were highlighted: the model developed by Singer for studies on income distribution in Brazil and adapted by Barros for use in epidemiological research, the model of Bronfman and Tuirán to study the Mexican demographics census and adapted by Lombardi for epidemiological research, the model proposed by Goldthorpe for socioeconomic studies in the UK and adapted by the Spanish Society of Epidemiology, and the model proposed by Wright for research in sociology and political science, which has also been used in population surveys in health. In conclusion, each of the models presented is consistent with their underlying theoretical concept, precluding the selection of one model over the others.

Social Class; Social Conditions; Models; Organizational; Social Sciences; Health Surveys

Authorship

Rita Barradas Barata

Manoel Carlos Sampaio de Almeida Ribeiro

Zilda Pereira da Silva

José Leopoldo Ferreira Antunes

Correspondence : Rita Barradas Barata. Rua Dr. Cesário Mota Jr, 61. 01221-020 São Paulo, SP, Brasil. E-mail: rita.barradasbarata@gmail.com

The authors declare that there are no conflicts of interest.

SCIMAGO INSTITUTIONS RANKINGS

Tables

Tables (5)

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Table 1
Goldthorpe class diagram ⁷7 . Goldthorpe J. Analysing social inequality: a critique of two recent contributions from economics and epidemiology. Eur Sociol Rev.2010;26(6):731-44. DOI:10.1093/esr/jcp046
https://doi.org/10.1093/esr/jcp046... (2010).

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Table 2
Goldthorpe ⁷7 . Goldthorpe J. Analysing social inequality: a critique of two recent contributions from economics and epidemiology. Eur Sociol Rev.2010;26(6):731-44. DOI:10.1093/esr/jcp046
https://doi.org/10.1093/esr/jcp046... (2010) diagram adapted by the Spanish Society of Epidemiology.

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Table 3
Diagram of 12 classes proposed by Wright ²⁷27 . Wrigth EO. Class, crisis & the State. London: Verso; 1978. (1978).

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Table 4
Strategy to operationalize the model of Singer ¹⁹19 . Santos JAF. Uma classificação socioeconômica para o Brasil. Rev Bras Ci Soc. 2005;20(58):27-46. DOI:10.1590/S0102-69092005000200002
https://doi.org/10.1590/S0102-6909200500... (1981) adopted by Barros ¹1 . Barros MBA. A utilização do conceito de classe social nos estudos dos perfis epidemiológicos: uma proposta. Rev Saude Publica . 1986;20(4):269-73. DOI:10.1590/S0034-89101986000400001
https://doi.org/10.1590/S0034-8910198600... (1986).

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Table 5
Diagram of operationalization of Bronfman & Tuiran ⁵5 . Bronfman M, Tuirán RA. La desigualdade social ante la muerte: clases sociales y mortalidade en la ni-ez. Cuad Med Soc.1984;29/30:53-75. (1984).

Table 1 Goldthorpe class diagram ⁷7 . Goldthorpe J. Analysing social inequality: a critique of two recent contributions from economics and epidemiology. Eur Sociol Rev.2010;26(6):731-44. DOI:10.1093/esr/jcp046
https://doi.org/10.1093/esr/jcp046... (2010).

Classes of service
I - Professionals with higher education, executives, and managers of large companies and major employers;
II - Professionals, managers, and administrators of small businesses or in positions of authority in a low hierarchy, such as supervisors of non-manual workers;
Middle Class
III - a) Workers in non-manual activities in administration or in commerce; b) non-manual workers in security activities or personal services;
IV - a) Small landowners and craftsmen with less than 25 employees; b) small owners and craftsmen without employees; c) farmers and self-employed extractivists;
V - Supervisors of manual workers;
Working Class:
VI - Skilled manual workers;
VII - a) Non-skilled manual workers in the secondary or tertiary sectors; b) non-skilled manual workers in the primary sector.

Table 2 Goldthorpe ⁷7 . Goldthorpe J. Analysing social inequality: a critique of two recent contributions from economics and epidemiology. Eur Sociol Rev.2010;26(6):731-44. DOI:10.1093/esr/jcp046
https://doi.org/10.1093/esr/jcp046... (2010) diagram adapted by the Spanish Society of Epidemiology.

I - Executives in the public administration or in companies with 10 or more employees and professionals with academic credentials or postgraduate degrees;

II - Executives in companies with less than 10 employees, professionals with academic credentials, senior technicians, artists, and sportsmen;

III - a) Administrative staff, administrative or financial management support staff, and personal services or security workers; b) self-employed workers; c) supervisors;

IV - a) Skilled manual workers, b) semi-skilled manual workers;

V - Unskilled workers.

Table 3 Diagram of 12 classes proposed by Wright ²⁷27 . Wrigth EO. Class, crisis & the State. London: Verso; 1978. (1978).

Owners	Non-owners (workers)

Bourgeoisie	Executives	Managers	Non-specialized managers	Control over the work process
Smallholders	Supervisors specialists	Supervisors	Non-specialized supervisors	Some control over the work process
Petite bourgeoisie	Experts	Skilled workers	Unskilled workers	Without control over the work process
	Expertise and educational credentials

Table 4 Strategy to operationalize the model of Singer ¹⁹19 . Santos JAF. Uma classificação socioeconômica para o Brasil. Rev Bras Ci Soc. 2005;20(58):27-46. DOI:10.1590/S0102-69092005000200002
https://doi.org/10.1590/S0102-6909200500... (1981) adopted by Barros ¹1 . Barros MBA. A utilização do conceito de classe social nos estudos dos perfis epidemiológicos: uma proposta. Rev Saude Publica . 1986;20(4):269-73. DOI:10.1590/S0034-89101986000400001
https://doi.org/10.1590/S0034-8910198600... (1986).

a) Business bourgeoisie − including employers with five or more employees and an income equal to or greater than 9 minimum wages;

b) Managerial bourgeoisie − technical workers, professionals with higher education, and executives;

c) Petite bourgeoisie − employers with up to four employees, an income of less than 9 minimum wages, and an established independent business;

d) Proletariat − employees in the field of commerce, services, or industry except civil construction;

e) Subproletariat − workers in the agricultural sector, civil construction or domestic services, self-employed workers without a business, and those not included in the economically active population.

Table 5 Diagram of operationalization of Bronfman & Tuiran ⁵5 . Bronfman M, Tuirán RA. La desigualdade social ante la muerte: clases sociales y mortalidade en la ni-ez. Cuad Med Soc.1984;29/30:53-75. (1984).

I − Bourgeoisie − Employers with five or more employees and income ≥15 minimum wages;

II − New petit bourgeoisie − employer with university training, with up to four employees and/or an income of <15 minimum wages; self-employed workers in the industrial sector, commerce field, or services, with university training; and workers with university training or in managerial positions in the industrial sector, commerce field, or services;

III − Traditional petit bourgeoisie − employer without university training, with up to four employees and/or an income of <15 minimum wages; self-employed worker without university training, business owner or skilled worker;

IV − Atypical proletariat − employee without university training and worker in managerial positions in the industrial sector, in activities not directly related to production, commerce field, and services;

V − Typical proletariat − self-employed worker in civil construction; skilled worker without university training and in a managerial position in the civil construction or other industrial areas;

VI − Subproletariat − self-employed worker or unskilled employee without university training and without a business.

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[1] Correspondence : Rita Barradas Barata. Rua Dr. Cesário Mota Jr, 61. 01221-020 São Paulo, SP, Brasil. E-mail: rita.barradasbarata@gmail.com