Occupational class, capitalist class advantage and mortality among working-age men.

BACKGROUND: Disparities in mortality have been firmly established across occupational grades and the incomes they earn, but this line of research has failed to include individuals' relationships to capital, as suggested by class analysists.
METHODS: According to Wright's classification, the research generated 10 mutually exclusive classes based on occupation and investment income: worker; capitalist worker; professional; capitalist professional; supervisor; capitalist supervisor; manager; capitalist manager; self-employed; and capitalist self-employed. The study participants (n=268 239) were randomly selected from the Statistics Finland population database and represent 33% of Finnish men aged 30-64 years. The mortality data were monitored over the 1995-2014 period.
RESULTS: The sociodemographic-adjusted HRs for mortality were lowest for capitalist managers (HR 0.50; 95% CI 0.36 to 0.69) as compared with that for workers without a capitalist class advantage. A positive occupational class gradient was found from managers to supervisors to workers. The capitalist class advantage independently affected the disparities in mortality within this occupational hierarchy.
CONCLUSION: Different occupational class locations protect against premature death differently, and the capitalist class advantage widens the premature-death disparities among the occupational classes. To monitor and explain social inequalities in health in a more nuanced way, future research on investment income as well as the operationalisation of the capitalist class advantage is encouraged. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.