Recovery From Schizophrenia: Psychiatry And Political Economy

Chapter 2Health, illness and the economyHow far do economic factors influence our birth and death, control our health,mold our behavior and identity and affect our sanity? We may look for theanswer to these questions by two methods—by studying the differences betweensocial classes and by calculating the human effects of fluctuations in the economy.SOCIAL CLASS, ILLNESS AND DEATHLower-class people in industrial society die younger. This much was clear to thestatisticians of the nineteenth century and continues to be true today. In 1842, theaverage age of death for different classes in various British centers of trade andmanufacturing was estimated to be as follows:The well-to-do classes enjoyed a lease of life more than double that of theworking classes. 1 The dramatic difference was largely accounted for by high infantmortality in the poorer classes and by deaths among adults from consumption,pneumonia, infectious diseases and other conditions associated with poverty,malnutrition and overcrowding. 2Class differences in life span persist in modern industrial society. According tothe British Registrar General’s figures, there is a clearly defined socialclass gradientin mortality rates. British working-class citizens run a greater risk of death at allages. In adults the difference in death rates is apparent over a wide range of causesfrom malignancy to heart disease. Where the cause of death is accidental or fromrespiratory or infectious disease, lower-class mortality rates are most dramaticallyelevated—from three to five times greater than for the highest social class. 3Throughout the Western world there is a similar relationship between socialclass and life expectancy. In nineteenth-century America, as in Britain, the ratio