Social mobility and mental health in a Swedish cohort.

Data from Project Metropolitan, a study of a Stockholm cohort born in 1953, is used to investigate the relationship between social mobility and mental health. The analysis was based on 6928 males and included data gathered on the parents of the cohort at birth and during childhood, at draft board examinations conducted at age 19 years, census records when the cohort was aged 27 years and hospital records for the period during which the cohort was aged 20-30 years. At the age of 19 years, the sons of unskilled working class parents had a prevalence of psychiatric disorder that was approximately twice that of those born into upper-middle class families and they were one-third as likely to be rated as having a high coping ability. There was a strong association between mental health and the occupational status of the cohort members themselves at the age of 27 years. The health of those not fully employed and, to a lesser extent, those classified as students, was especially problematic. The sons of parents who exhibited downwards mobility during the childhood of the cohort had a greater risk of psychiatric disorder during early adulthood than those with parents who either rose in status or remained static. Intergenerational mobility, comparing the occupation of sons at the age of 27 years with that of their fathers at the time of their birth, was associated with a clear gradient in mental health; sons who rose in status had high ratings for coping ability and a low risk of psychiatric disorder, those who fell in status had low ratings for coping ability and a relatively high risk of impairment. Comparisons between Project Metropolitan and the British National Child Development Study (NCDS) cohort suggest that the selective effects of health may be more important in determining intergenerational social mobility that has sometimes been claimed.