The prediction of different experiences of longterm illness: a longitudinal approach in Sweden.

STUDY OBJECTIVE To analyse the role played by socioeconomic factors and self rated general health in the prediction of the reporting of severe longterm illness, and the extent to which these factors explain social class differences in the reporting of such illness. DESIGN Analysis of panel data from the survey of living conditions, conducted by Statistics Sweden over the years 1979-81 and 1986-89. SETTING A random sample of the Swedish population, interviewed in 1979-81 and then re-interviewed in 1986-89. PARTICIPANTS A representative sample of 3889 employed Swedish people, aged 16-65 years. MAIN RESULTS Socioeconomic and individual factors predict severe longterm illness regardless of the kind of reported disorder from which the subject suffers. The main predictive factor involved is health self rated as fair/poor, but exposure to high physical job demands proved to be the main explanation of the role played by socioeconomic class. There was a significant interaction effect between self rated general health and physical job demands with regard to the experience of severe illness. CONCLUSIONS The results of the study strengthen the hypothesis that manual workers are not only more exposed to causes of illness that have important individual and social consequences, but also to the personal factors that determine different experiences of illness. Interaction between these two kinds of factors (job demands and self rated health) suggests that socioeconomic and individual factors play different but complementary roles in the causal process leading to the experience of severe longterm illness.