Life stress, support and class inequality

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Abstract
This paper examines the relationships between stress, social support, class, health and health-service use in a sample of mothers and children from a predominantly socially disadvantaged population. The initial sample size was 509; the sample was drawn from 4 cities, 2 in the south of England and 2 in the Midlands. Stress, measured using a standard life-events inventory, was found to be more common amongst the most disadvantaged women; the women who reported the most stress during pregnancy also reported the most stress 1 year after the birth. There were few direct relationships between stress and social support; those that did exist were in the direction of more life events being associated with less support. The occurrence of life events was strongly related to the mothers' psychological and physical health; there were also relationships with the babies' health, especially at 1 year. Events of particular importance were those relating to money, problems with partners and paid work. Women who reported life events were more likely to use the health services both for themselves and for their babies. A model is proposed for understanding the processes linking the material and cultural circumstances associated with class and health outcomes. In this model, social support and health-service use occupy contrasting roles as factors mediating these relationships. While health-service use is associated with an increased risk of adverse health outcomes, social support is health-promoting.

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