A team from Penrith, Australia, examined the relationships between social class and gastrointestinal symptoms in a population sample.
A total of 15,000 individuals were included in the study. A postal questionnaire was sent to each subject (response rate 60%). The prevalence of 16 troublesome gastrointestinal symptoms was determined in the subjects, and compared with a validated composite measure of socioeconomic status (index of relative socioeconomic disadvantage).
Comparisons across social class were explored for 5 symptom categories (esophageal symptoms, upper dysmotility symptoms, bowel symptoms, diarrhea, and constipation).
|Most pronounced symptoms in lowest social class:|
- Upper dysmotility
Results were reported as age standardized rate ratios, with the most advantaged social class as the reference category.
There were clear trends for the prevalence rates of all gastrointestinal symptoms to increase with decreasing social class. These trends were particularly strong for the five symptom categories.
The researchers found that lower social class was associated with a significantly higher number of symptoms reported overall. It also correlated with a higher proportion of individuals reporting 1-2 symptoms and more than 5 symptoms.
In both sexes, the most pronounced effects for subjects in the lowest social class were found for constipation (males: rate ratio 1.83; females: rate ratio 1.68) and upper dysmotility symptoms (males: rate ratio 1.45; females: rate ratio 1.35).
Esophageal symptoms and diarrhea were not associated with social class.
Author P Bytzer, of the Nepean Hospital, Penrith, concluded on behalf of the group, "Troublesome gastrointestinal symptoms are linked to socioeconomic status, with more symptoms reported by subjects in low socioeconomic classes.
"Low socioeconomic class should be considered a risk factor for both upper and lower gastrointestinal symptoms."