Social class and psychological ill-health during ... - Wiley Online Library

Roy Payne, Peter Warr and Jean Hartley

Social class and psychological ill-health during unemployment Abstract This study explores psychological health and the experience of being unemployed for between 6 and 11 months in two social class groups: unskilled and semi-skilled workers v. white-collar, managerial and professional workers. The respondents were British married men aged between 25 and 39. Information was obtained through interviews about financial and other problems, perceived threats associated with unemployment, anxiety, depression, general psychological distress and ratings of general health. It was expected that the working-class sample wotild exhibit poorer psychological health than the middleclass, but this was not confirmed. Medium-term unemployment appeared to have a homogenizing effect, with similarly poor health in both social class samples, although working-class respondents reported significantly greater financial problems and difficulties in filling the time.

Introduction

In studying the effects of unemployment upon psychological health, research is increasingly examining vadables which may mediate the effects of being without a job. For example, age differences have been shown to be of considerable importance, with greatest ill-health among middle-aged unemployed people (Daniel, 1974; Hepworth, 1980), and length of unemployment has been found to be positively associated with ill-health, at least up to around six months without a job (Jackson and Warr, 1984). Social class appears likely to be a further important mediating factor, although the evidence available to date is open to conflicting interpretation. On the one hand several writers have suggested that psychological ill-health among working-class unemployed people will be greater than among the middle-class unemployed. Such a difference between social classes is typically found in general population surveys (e.g. Kessler and Cleary, 1980; Townsend and Davidson, 1982), and might Sociology of Health and Illness Vol. 6 No. 2 1984

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be expected to carry over to unemployed samples. That has been reported by Rundquist and Sletto (1936) in terms of 'general adjustment' and 'morale', by Cohn (1978) in respect of satisfaction with self, and by Hep worth (1980) in respect of minor psychiatric morbidity and life satisfaction. Warr and Parry (1982) concluded from their literature review and data analyses that among women in general (amongst whom there is no general correlation between psychological health and employment status) having a job is likely to benefit the psychological health of working-class women but not those in middleclass samples. Some studies of middle-class people who have lost their jobs have suggested that unemployment may have relatively minor impact in many cases. Little (1976) found that 48 per cent of a sample of 100 unemployed middle-class American men were 'beginning to think that losing my technical/professional position might not have been such a bad break after all'. Hartley (1980) recorded scores on global selfesteem which were very similar in employed and unemployed samples of British managers, and Fineman's(1983)study of 100 British managers and professionals indicated that many did not experience strong negative effects of unemployment. Research by Estes and Wilensky (1978) has emphasized that financial strain is strongly associated with general psychological distress during unemployment, and it appears likely that financial strain will be less among middle-class than working-class samples. On the other hand, Kaufman (1982) has suggested that 'since the identity and life satisfaction of the highly educated are so strongly intertwined with their work, it is reasonable to expect that professionals would experience more severe psychological problems resulting from joblessness than would those in other occupations' (p. 23). He concludes that 'although the evidence is not completely consistent, the weight of support favors the conclusion that the psychological effects of unemployment are likely to be more extreme for professionals than for other workers' (p. 24). To back up this argument, Kaufman cites Brenner's (1973) suggestion that high social-class people suffer more during an economic downturn. However, Brenner's inquiries have been at the aggregate level and his results do not have direct implications about the impact of unemployment on particular individuals. A study by Catalano and Dooley (1983), which linked the aggregate and individual levels of analysis, found evidence that economic contraction increases the incidence of illness and injury by raising the incidence of undesirable job and financial events. However, this was observed for middle-class respondents only; no such evidence was found for higher- and lower-class respondents.

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In view of these inconsistencies there is clearly need for additional research into the importance of social class as a mediator of unemployment. This paper descdbes an individual-level investigation, which controls for possible extraneous effects of sex, age, colour, length of unemployment and madtal status. On balance, it was believed that the pdor evidence warranted a prediction of greater psychological ill-health in an unemployed working-class sample than among unemployed middle-class respondents. The study was designed to test this expectation by measuring psychological health and several other aspects of expedence dudng unemployment.

Method' 1 Samples Two samples of unemployed men were drawn from those registered at 54 Unemployment Benefit Offices in the mainland United Kingdom. They were approached in the vicinity of the offices by trained interviewers of a survey research organization and invited to take part in the study. The interviewers had no formal contact with the Benefit Offices, and had no access to information held there in respect of the individuals they approached. Non-white and registered disabled men were excluded, and a filtering process ensured that those in the study were all marded, aged between 25 and 39, and had been unemployed for between 6 and 11 months inclusive. This homogeneous group was divided into two samples on the basis of social class, defined in terms of the occupational level of a person's last job. A middle-class sample was defined in terms of occupational levels A, B and Cl of the conventional classification, where 'A' represents higher managedal, administrative or professional jobs, 'B' covers intermediate jobs of those kinds, and 'CT includes junior managerial, administrative or professional jobs and those of other whitecollar and clerical employees. The middle-class sample contained 203 members. A working-class sample (N = 196) was drawn from occupational level D, covering semi-skilled and unskiUed manual workers and casual labourers (see note). Note that C2 occupations, those of skilled manual workers, who represent approximately one third of the workforce, were excluded; this was in order to ensure separation of the samples on the social class vadable. The validity of this separation was supported by information gathered from respondents about their educational achievements. There were highly significant differences (p < .001) between the two samples in terms of age at which they finished full-time education, educational qualifications, and technical qualifications.


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It was not possible to determine the rates of participation or refusal among potential interviewees of the two social classes, since people approached made the decision whether or not to take part in the study before their previous job, age, marital status and length of unemployment could be ascertained. Many of those initially agreeing to take part were excluded as falling outside the sampling requirements in terms of length of unemployment, marital status or age; and many of those declining to participate would no doubt have been excluded on the same grounds, 2 Measures Four groups of measures were collected: biographical, health, perceptions of the situation of being unemployed and measures about beliefs relevant to employment and control. The usual biographical variables were supplemented by questions about financial circumstances and questions about how the individual became unemployed. The health measures were ones widely used within community studies of mental health (e.g. the General Health Questionnaire) or ones previously shown by the authors to tap feelings relevant to stressful situations (e.g. strain and pleasure yesterday, Warr and Payne, 1982). The use of such measures allows compadson with other data sets available to the authors. Some new measures were developed to explore people's perceptions of their situation. These covered problems, opportunities, social supports and feelings of threat if unemployment continues. Two individual difference measures were included since they have both been shown to affect the way people react to unemployment. Both are measures of beliefs/values. One measures the individual's concerp to be in employment, employment commitment, and the other measures the degree to which an individual believes he or she is in control of what happens to him/her. It is called external control. The moderating effects of these last two variables on the relationships amongst the other vadables are explored elsewhere (Payne and FJartley, 1984). The present paper concentrates on comparing the two social class groups. The data were collected by interviews and tliese were cqnducted in the respondent's home, though a small nurpber took place in the Unemployment Benefit Office or a nearby location if the respondent wished it. In order to assess comprehensively sirnilarities and differences between the two social-class samples the following areas \yere examined. Health and well-being 1 General Health Questionnaire Aspects of psychological ill-health v^ere measured through the General Health Questionnaire (GHQ). This is a self-administered screening test designed for detecting non-psychotic

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psychiatdc disorder (Goldberg, 1972, 1978). The 12-item version was here used as a measure of general psychological distress, supplemented by the 7-item anxiety and depression scales (Goldberg and Hillier, 1979). Three scores were thus available for each person: general distress (identified later as GHQ-12), anxiety and depression. Respondents are asked to compare themselves in the past few weeks with how they have usually felt in the past few years. An illustrative item from the GHQ-12 is: 'Have you recently felt constantly under strain?' (Not at all. No more than usual. Rather more than usual. Much more than usual; scored from 0 to 3 respectively). Table 8 contains all GHQ items and indicates which belong to each subscale. To facilitate comparison with other studies, means are given for two scoring procedures. The first values are totals across the 12 items scored 0, 1, 2 or 3 (the so-called Likert method), and the second procedure (used mainly in the psychiatdc literature) treats responses of 2 or 3 as symptomatic (recoded as 1) retaining non-symptomatic responses with the weight of zero. The potential range is from 0 to 36 and from 0 to 12 in the two procedures. In screening studies individuals scoring more than 2 out of 12 on the dichotomous scoring procedure are typically classed as potential cases for receiving psychiatdc help. General distress scores (GHQ-12) from the middle-class sample were found to be correlated 0.88 and 0.66 with anxiety and depression, and the latter scores were intercorrelated 0.55. For the working-class sample these values were 0.89, 0.71 and 0.64 respectively. These intercorrelations are typical of other investigations (Goldberg and Hillier, 1979). 2 Strain and pleasure on the preceding day In order to obtain a direct assessment of the prevalence of strain in the two social-class groups, respondents were asked how they were feeling on the preceding day; prevalence of pleasant feelings was similarly assessed. Single questions covered each of 'unpleasant emotional strain' and 'feeling very pleased with things' yesterday. Responses were on a six-point dimension from All of the Time to None of the Time, scored from 5 to 0 respectively. Further details and results from a large random British household survey are described by Warr and Payne (1982). In the present study the strain and pleasure items were intercorrelated —0.54 and —0.45 for the middle-class and working-class samples respectively. 3 Reported health A summary assessment of general health was obtained by respondents rating their health in the past month, as Excellent, Good, Fair, Poor or Very Poor. These responses were scored from 5 to 1 respectively.

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4 Reported health change in the past year Reports of health were immediately followed by the question: 'How does that compare with about a year ago, when you had a job?' Responses were Much Better, A Little Better, The Same, A Little Worse, and Much Worse, scored from 5 to 1 respectively. Perceptions of the situation 1 Perceived problems An 18-item scale was constructed to measure the severity of the problems present in the person's current life (see Table 3). Each item could be described by respondents as A Big Problem, A Middling Problem, A Little Problem, or No Problem, with responses scored 4, 3, 2, 1 respectively. The scale produced an Alpha coefficient of internal reliability of 0.87. The mean score for the combined sample was 45.30 and the standard deviation was 11.06. 2 Perceived threats of continuing unemployment Fineman and Payne (1981) have shown that perceptions of situations as having high role ambiguity or high role overload do not alone predict experiences of strain: it is necessary to know whether the overload/ambiguity are felt to be threatening. A measure was thus designed to assess the perceived threat of continued unemployment (see Table 4). This consists of 16 items which were preceded by these words: 'We hope this won't happen to you, but just imagine for a moment that you are still unemployed in 6 months time. Putting yourself in that position, how likely do you think it is that each of these things I read out would happen to you.' The respondent could answer: UnUkely to Happen, Not Sure, Likely to Happen, Has Already Happened; and these were scored 1 to 4 respectively. The Alpha coefficient of internal reliability for this scale was 0.84, the overall mean 24.36 and the standard deviation 6.95. 3 Perceived opportunities from unemployment Fourteen items were constructed in order to operationalize the concept of perceived opportunity in unemployment. Respondents were asked, 'Since being unemployed have you felt that being out of a job has opened up opportunities for doing new things that you would like to try?' Respondents saying 'Yes' were further asked if they had: Followed it up and were still doing so. Followed it up but had now finished. Had not followed it up but might, or Had not followed it up and won't. The responses were scored 4 to 1 respectively so that a high score represented high perceived opportunity. The scores were added to form a total score and the Alpha coefficient was 0.69. The items for the scale are in Table 5. The overall mean was 28.28 and the standard deviation 10.88.

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4 Supports-constraints Following a model of occupational stress (Payne, 1979) a scale was developed to measure the degree to which people perceive that individuals and organizations help or hinder them in coping with the problems of being unemployed. The scale consists of 13 items, and the respondents are asked, 'In the past month please say how helpful each of the following has been.' The response categories are: Been Very Helpful, Been Quite Helpful, Been not at all Helpful, and Made Things More Difficult. These were scored 4 to 1 respectively. Various weighting procedures were tried, for example, counting all the 1 scores as a measure of constraint, and treating the rest of the scores as an index of support. However, the 'Made Things More Difficult' constraint category was so rarely used that the most reliable scale was achieved by a simple summation across all 13 items using the 1-4 scale. The Alpha coefficient was 0.63, the mean 6.47 and the SD 3.19. Example items are: my wife; groups set up to help the unemployed; financial organizations such as banks, loan companies, building societies, etc. Beliefs/values 1 Employment commitment In view of suggestions (e.g. Kaufman, 1982), that paid work has greater personal salience for middle-class people, a measure was included to assess respondents' commitment to employment. This was a six-item scale where each item was rated on a five-point scale varying from Disagree a Lot (1) to Agree a Lot (5). Items include: Having a job is very important to me; If unemployment benefit was really high I would still prefer to work; and a similar question about winning a great deal of money. The Alpha coefficient for the total scale was 0.69, the mean was 27.20 and the standard deviation 6.66. 2 Belief in external control In order to examine possible social class differences in personal control over environmental pressures, a fouritem scale was constructed. Illustrative items are, 'Many times we might just as well decide what to do by tossing a coin', and 'When I make plans I'm almost certain I can make them work' (reversed). Responses were in terms of the five alternatives used for employment commitment. Alpha was 0.64, the mean was 10.94 and the standard deviation was 4.16. The items in this measure are those showing the highest itemtotal correlations in Rotter's (1966) locus of control scale. Biographical Most of these measures were simple category responses and they are


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dealt with as needed in the results section. One item about financial circumstances needs descdbing. Serious financial worries A single item was used to assess financial anxiety in the two social class groups: 'Thinking back over the past month, how often have you had serious financial wordes?' (Never, Hardly Ever, Frequently, Nearly All the Time, All the Time; scored from 0 to 4 respectively.)

Results The respondents in the working-class sample were significantly more likely than those in the middle-class sample to have had recent episodes of unemployment. Only 45 per cent of the working-class group had escaped unemployment in the five years before the current episode; 25 per cent had been unemployed once, and 30 per cent twice or more. Corresponding figures for the middle-class group were 71 per cent never unemployed in the previous five years, 19 per cent unemployed once, and 10 per cent unemployed twice or more. The number of previous unemployment pedods was unrelated to any of the psychological or health variables, within either of the samples. Associated with the differential unemployment frequency, the working-class group had been more likely to change employers in the recent past. Only 50 per cent had had a single employer in the past two years compared to 68 per cent of middle-class respondents (p < .01). Furthermore, 34 per cent of working-class respondents descdbed the job they held before the present unemployment as 'not my normal work', but for the middle-class group this figure was only 20 per cent In descdbing how they left their most recent job, 52 per cent of middle-class respondents indicated that they had been made redundant, 8 per cent that they had been dismissed, 8 per cent that a fixed term contract had ended, 3 per cent that they had left for health reasons, and 28 per cent that they had left for other reasons. Figures for the working-class group were very similar: 56, 10, 10, 4 and 20 per cent respectively. The middle-class group was significantly more likely (p < .05) to have refused offers of jobs as unsuitable since becoming unemployed on this occasion: 9 per cent reported turning down one job offer, and 10 per cent reported turning down more than one job offer. For the working-class group the figures were 9 and 2 per cent respectively.

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Table 1 Reported weekly family income as a proportion of income when in a job (%)

More than before Same as before About three quarters About half About a quarter Less than a quarter

Middle class

Working class

3 3 18 43 21 11

4 10 17 46 13 9

Financial Position In almost every respect the working-class men reported a worse financial position than that of the middle-class respondents. Members of the working-class sample were more often the sole household wage-eamer (71 against 63 per cent). Their wives were less likely to be full-time employed (9 compared to 23 per cent of the middle-class wives), but more likely than middle-class wives to have part-time employment (16 against 8 per cent). The middle-class group reported slightly more frequently that other wage-earners (relatives, for example) were present in the household (6 against 4 per cent). Members of each sample were asked: 'Putting together all sources of income in the family, which phrase on this card best describes the amount of money you as a family have to spend each week now compared with when you had a job?' Response alternatives and results are shown in Table 1. It can be seen that 75 per cent of middle-class and 68 per cent of working-class respondents report now receiving half or Table 2 Reported frequency of serious financial worries in the past month (%)

Never Hardly ever Frequently Nearly all the time All the time

Middle class

Working class

24 12 24 22 18

12 17 16 30 25


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less of their previous family income. The middle-class respondents report a significantly lower proportion (p < .05, by t-test on the complete set of values), but their previous income was of course higher than that of the working-class group. Reported frequency of serious financial worries in the past month is summarized in Table 2. Forty per cent of middle-class respondents and 55 per cent of working-class respondents reported serious worries nearly all the time or all the time. The two distributions of scores were significantly different from each other (p < .01, by t-test on the complete set of values), with greater financial strain in the workingclass group. Answers to other questions cast further light on this difference. Fifty-five percent of the working-class group had, since becoming unemployed, 'to borrow money to see me through', compared to 40 per cent of the middle-class group. Of the working-class group, 36 per cent reported borrowing up to £100 in total, 16 per cent had borrowed between £100 and £500, and 3 per cent had borrowed more than £500; comparable figures for the middle-class group were 13, 14 and 13 per cent. Similarly when asked whether they had '/zacf to sell anything while unemployed, because of being unemployed' more working-class respondents replied in the affirmative: 41 against 32 per cent. However, there was no difference in the proportion of those with hire purchase agreements who had to give them up while unemployed: 14 and 16 per cent of the middle-class and working-class groups. Reported problems Several problems during unemployment were also reported to be worse by the working-class sample. Table 3 presents the findings for each of the 18 problem items and the overall mean item score. The table shows the proportion of each group indicating an item to be a 'big problem' (response alternative 4; see the note to the table), as well as mean scores. The right-hand column shows the level of statistical significance based on t-tests comparing the mean scores for each of the two social classes. It can be seen that both groups view getting a suitable job offer as their biggest problem, with financial difficulties next in magnitude. The working-class respondents are significantly more likely to report as problems two of the three financial items (numbers 2 and 3 in Table 3). The working-class group also report significantly more difficulty in sustaining job-seeking activity, in being unsure about the future, in finding things to do, and in dealing with officials and people who are unpleasant to them. Note, however, that the last problem is very

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Table 3 Reported problems in the past month: findings for unemployed middle-class and working-class men %Big problem 1 Managing on the money I have 2 Not being able to do things I like to do because I'm short of money 3 Not being able to do things I need to do because I'm short of money 4 Getting the offer of a suitable job 5 Keeping myself looking for a job 6 Not knowing what is going to happen to me in the future 7 Keeping myself from being bored 8 Finding enjoyable things to do 9 Finding useful ways to spend my time 10 Stopping myself from getting depressed 11 Stopping myself from worrying or getting tense 12 Concentrating on what I'm doing 13 Being decisive about things 14 Keeping the family cheerful and contented 15 living up to what other people expect of me 16 Dealing with people at the unemployment, tax and social security office 17 Coping with people who are unpleasant with me because I'm unemployed People avoiding me deliberately 18 Mean score Notes:

Mean values

Middle Working Middle Working P 70 60 3.38 3.52 n.s.

57

75

3.23

3.56

.001

52

74

3.07

3.52

.001

91

93

3.84

3.84

n.s.

20

39

2.25

2.71

.001

54

64

3.06

3.30

.05

36 22

51 28

2.59 2.18

3.02 2.53

.001 .01

18

30

2.07

2.51

.001

27

36

2.48

2.63

n.s.

32

37

2.61

2.67

n.s.

19 9

20 14

2.04 1.73

2.12 1.91

n.s. n.s.

25

36

2.38

2.49

n.s.

23

25

2.00

2.02

n.s.

24

28

2.00

2.28

.05

4 2

9 2

1.30 1.13 2.41

1.53 1.20 2.63

.01 n.s. .001

The items were during the interview presented in random order. Response alternatives were: Big problem (4); Middling problem (3); Little problem (2), No problem (1).

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infrequently encountered. At the bottom of Table 3 are given the overall mean problem scores, which can be seen to be significantly higher for the working-class group. Perceived threats

Overall scores in terms of the threat felt by respondents should they still be unemployed in .6 months' time were found to correlate 0.60 with scores on the Problems scale. Comparisons of individual items and total scores of the social-class groups appear in Table 4. As well as results of t-tests, the table contains the proportion of respondents answering that an event 'Had already happened' or 'Was likely to happen' (see the note to the table). The major threats perceived by these unemployed men are associated with lack of money, psychological deterioration and the loss of job skills. In three cases there are significant differences between the groups. Working-class respondents are significantly more threatened by money problems and the fear of becoming permanently unemployable, and middle-class respondents report a greater probability of having to move into poorer housing. However, the latter two threats are relatively infrequent. Note also that loss of family support (items 14 to 16) is rarely seen as a threat. The overall level of threat for the two social classes is almost exactly the same, though the means which are just above 1.5 indicate that on average people are answering between 'not sure' and 'unlikely'. The absolute level of reported threat is thus not generally high, with the significant exception of financial threat (means of 2.35 and 2.63). Supports-constraints Social support has been shown to reduce the effects of stressors in occupational (House et al., 1979) and non-occupational situations (Brown and Harris, 1978). Thirteen questions were asked about the support received from individuals (wife, friends, shopkeeper) and organizations (educational, financial, voluntary). In only two cases were there differences in reported support between the two social classes. The working-class group reported that they had more often found local shopkeepers to have been 'quite, or very helpful'(18 v. 11 per cent, p < .05). More middle-class respondents indicated that they found financial institutions helpful (38 compared to 18 per cent, P