David Blane

The present article reviews, in relation to quantitative work on the social structure, papers published inSociology of Health and Illnessduring its first 25 years. Each issue published during the years 1979–2002 has been examined; and quantitative papers, relating to various aspects of the social structure, have been identified. Such papers are found to have formed a minor but substantively significant theme within the Journal. These contributions situate the journal between sociology and social epidemiology. Articles in the Journal, for example, have been part of sociological debates about the measurement of social class, and of social epidemiological debates about the relationship between income distribution and population health. The contribution ofSociology of Health and Illnessto a number of such debates is reviewed. The article concludes that the present situation, in particular the intellectual crisis in social epidemiology and social science investment in large data sets, gives the Journal the chance to build on this distinguished tradition by encouraging, through its publication policy, the further development of quantitative medical sociology.

The present issues of the IJE contain eight reports of socioeconomic differences in health. These articles illustrate a number of traditional themes and point to new directions. The papers come from a range of countries—Australia, Denmark, Finland, Italy, The Netherlands, Scotland and Sweden—thereby demonstrating once again^1,2 the ubiquity of socioeconomic inequalities in health, at least in the rich countries of the world.

External cause mortality affects disproportionately those at younger ages and, when age at death is taken into account, external causes are of comparable importance to heart disease and cancer. The present paper uses Years of Potential Life Lost (YPLL), a measure of mortality which includes age at death, to examine trends in external cause mortality, by social class, in England and Wales. Deaths from external causes have fallen most in the more advantaged social classes, producing wider inequalities. Different categories of external cause have changed in opposite directions; traffic accidents have fallen but suicides have increased. Suicide and traffic accidents remain prime policy targets. A new initiative on traffic accidents is proposed.

STUDY OBJECTIVE To investigate whether there is a mismatch within Britain between climate severity and housing quality (“inverse housing law”) and whether this mismatch is associated with respiratory health. DESIGN, SETTING AND PARTICIPANTS Cross sectional observational study. Britain (Scotland, Wales and England). The 3023 male and 3694 female Health and Lifestyle Survey participants with valid data available on all relevant items. MAIN RESULTS Geographical mapping shows a mismatch between climate severity and housing quality. Individual level analysis shows that lung function is associated with climate and housing, and their interaction, independently of cigarette smoking status. The physical quality of the housing seems to be most important to respiratory health in areas with harsh climate. CONCLUSIONS Interpretation must be cautious because cross sectional data have been used to investigate processes that are longitudinal and, possibly, selective. Nevertheless, there does seem to be an “inverse housing law”, such that some of the worst quality housing is found in areas with severe climate; and, on the balance of probabilities, this inverse housing law affects respiratory health.