Class, stratification and inequalities in health: A comparison of the Registrar-General's Social Classes and the Cambridge Scale

Using published standardised mortality ratios for individual occupational groups in 1981, the value of the Registrar-General's Social Class schema for analysing health inequalities is compared with an alternative approach to the measurement of social stratification, the Cambridge Scale. A major issue is the extent to which the social classes really constitute social groups with a high degree of internal homogeneity and with clear boundaries between them. It is shown that, in relation to mortality ratios, they do not and that the stratification order is closer to a continuous hierarchy. The Cambridge Scale is to be preferred on both theoretical and empirical grounds: being constructed on a much sounder basis and superior in an explanatory sense. The advantages of a continuous measure are further explored by looking at the mortality ratios for malignant neoplasms and coronary heart diseases in the broader context of material factors (average earnings) and lifestyle (smoking).