Social factors and atopic dermatitis

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Abstract
Socioeconomic status, health and epidemiology The incidence of many diseases varies, sometimes considerably, according to social and economic conditions, culture and other environmental factors (Marmot, 1996). Socioeconomic status and social class have therefore become important concerns within epidemiology, and an increasing proportion of mortality and morbidity in developed and developing nations can now be explained by the growth in chronic disease with multifactorial aetiologies. Lifestyles and behaviour, heavily influenced by social factors, are now seen as crucial in health and disease. There is a long tradition in Britain, perhaps less marked in some other countries, of public health interest in socioeconomic conditions and health (Macintyre, 1997). The well known Black Report, published in 1980 by the Department of Health and Social Services, concluded that marked differences in mortality rates existed between the occupational classes. In particular, the report confirmed the negative social class gradient for many diseases with a deterioration of the health experience and higher risk of premature death occurring in the unskilled and semi-skilled manual classes (class IV and V) relative to class I. These differences, the report suggested, could be understood largely in terms of specific features of the socioeconomic environment such as work accidents, overcrowding and cigarette smoking, all of which are class related in Britain and have clear causal significance in terms of health status (Townsend & Davidson, 1992). In Britain, the occupation of the head of the family has traditionally been used as an approximate measure of socioeconomic status.
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