Section 6 in Chapter 1 discussed variations in smoking rates between different occupational levels. Australian and British research has shown that mortality rates for the diseases for which smokers are known to be at high risk are higher among individuals in lower socioeconomic groups.(162,163,164)
Research into male lung cancer death rates by occupation has shown that during the 1970s, rates were lower among those in white collar occupations, indicating that these groups have had lower smoking rates than blue collar groups for some time.(162)
Doctors, dentists and lawyers and those of similar professional status had the lowest rate, at 19.9 per 100,000. Teachers, scientists, managers, executives, farmers and those of similar status had a rate of 35.3 per 100,000. Technicians, clerical workers, salesmen, farm labourers, mechanics and those of similar status had a rate about twice that of the lowest group, at 41.3 per 100,000. Builders' labourers, miners, storemen, council labourers, domestic service workers and those of similar status had the highest death rates from lung cancer, around three times that of the lowest group, at 54.7 per 100,000.
Melbourne research examining cancer incidence and mortality related to socioeconomic status has shown that lung cancer is clearly more prevalent among lower socioeconomic groups and less prevalent among higher socioeconomic groups. Between 1979 and 1983, the lowest socioeconomic group experienced a mortality rate from lung cancer almost 50% higher than that of the highest socioeconomic group.(165) Analysis from the Australian Institute of Health and Welfare has estimated that between 1985-1987, males of lowest occupational prestige experienced 260% more lung cancer than those in the highest bracket.(163)
As well as reflecting smoking behaviour, higher disease rates among members of the lower socioeconomic groups may also reflect some degree of occupational exposure to carcinogens (see Section 3.10 above).
Smoking is a major avoidable risk factor for cardiovascular disease (CVD). Other risk factors include raised blood-cholesterol and triglyceride levels, raised blood pressure, being overweight, having diabetes mellitus, and being physically inactive. Psychological stress and alcohol are also implicated.(14)
Lower socioeconomic groups carry a greater burden of cardiovascular disease in Australia,(162,166) reflecting a greater clustering of most risk factors.(167) The lower risk factor levels observed among upper socioeconomic groups are probably due to these groups having better access to information, and having modified their disease risk through lifestyle changes.(166)
Research by the Australian Institute of Health and Welfare has shown that working age adults with a low educational level experience increased levels of bronchitis and emphysema. Males experience 70% more bronchitis and emphysema than the most highly educated group, and poorly-educated females report 50% more of these diseases than their better educated counterparts.(163)