Scandinavian Journal of Public Health, 2009; 37: 826–838 ORIGINAL ARTICLE Capitalists, managers, professionals and mortality: Findings from the Barcelona Social Class and All Cause Mortality Longitudinal Study CARLES MUNTANER 1,2 , CARME BORRELL 3,4,5 , JUDIT SOLA ` 3 , MARC MARI ´ -DELL’OLMO 3,4 , HAEJOO CHUNG 1 , MAICA RODRI ´ GUEZ-SANZ 3,4 , JOAN BENACH 4,6 & SAMUEL NOH 2 1 Center for Addictions and Mental Health, University of Toronto, Toronto, Canada, 2 Institute forWork and Health, Toronto, Canada, 3 Age `ncia de Salut Pu ´ blica de Barcelona, Barcelona, Spain, 4 CIBER Epidemiologı ´a y Salud Pu ´ blica (CIBERESP), Spain, 5 Universitat Pompeu Fabra, Barcelona, Spain, and 6 Health Inequalities Research Group, Employment Conditions Knowledge Network Research Unit, Universitat Pompeu Fabra, Barcelona, Spain Abstract Aims: To examine the effects of Neo-Marxian social class (i.e. measured as relations of control over productive assets) and potential mediators such as labour-market position, work organization, material deprivation and health behaviours upon mortality in Barcelona, Spain. Methods: Longitudinal data from the Barcelona 2000 Health Interview Survey (n ¼ 7526) with follow-up interviews through the municipal census in 2008 (95.97% response rate) were used. Using data on relations of property, organizational power, and education, social classes were grouped according to Wright’s scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled and unskilled workers. Results: Social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class positions for men but not for women. Workers (hazard ratio 1.60, 95% confidence interval 1.10–2.35), managers and small employers had a higher risk of death than capitalists. Conclusions: The extensive use of conventional gradient measures of social stratification has neglected sociological measurements of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the ‘‘contradictory class location hypothesis’’, additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers. Key Words: Epidemiological methods, follow-up, mortality, social class Introduction There has been a surge in empirical and theoretical research on Neo-Marxian social class (NMSC)- based health inequality. According to this concept, social class represents an individual’s social position in regard to the ownership and control of physical, financial and organizational resources of production. As such, personal class position has important consequences for the life of the individual and members of the person’s family. For example, legal rights and power to control productive assets deter- mine an individual’s ability to acquire desirable income, which, in turn, determines, in large part, the individual’s standard of living. Those who are in the ‘‘business owner’’ class hire ‘‘workers’’ and extract labour from them, while those in the ‘‘worker’’ class are compelled to find employment and perform labour for those in the ‘‘business owner’’ class. In this respect, class as a social concept is based on theoretical grounds, which describe economic and power relations at work and define explicitly relational mechanisms of property, management, ownership, and control [1,2]. Social class theories also explain how economic inequalities are generated Correspondence: Dr Carme Borrell, Placa Lesseps 1, 08023, Barcelona, Spain. Tel: + 34 93 202 7771. Fax: + 34 93 368 6913. E-mail: cborrell@aspb.cat (Accepted 21 July 2009) ß 2009 the Nordic Societies of Public Health DOI: 10.1177/1403494809346870 at PENNSYLVANIA STATE UNIV on May 11, 2016 sjp.sagepub.com Downloaded from