• Tim Doran, Frances Drever, and Margaret Whitehead.
• Department of Public Health, University of Liverpool, Liverpool L69 3GB. timdoran@liverpool.ac.uk
• BMJ. 2004 May 1; 328 (7447): 1043-5.

ObjectiveTo examine individual social class inequalities in self rated general health within and between the constituent countries of Great Britain and the regions of England.DesignCross sectional study using data from the 2001 national census.SettingGreat Britain.ParticipantsAdults aged between 25 and 64 in Great Britain and enumerated in the 2001 population census (n = 25.6 million).Main Outcome MeasuresEuropean age standardised rates of self rated general health, for men and women classified by the government social class scheme.ResultsIn each of the seven social classes, Wales and the North East and North West regions of England had high rates of poor health. There were large social class inequalities in self rated health, with rates of poor health generally increasing from class 1 (higher professional occupations) to class 7 (routine occupations). The size of the health divide varied between regions: the largest rate ratios for routine versus higher professional classes were for Scotland (2.9 for men; 2.8 for women) and London (2.9 for men; 2.4 for women). Women had higher rates of poor health compared to men in the same social class, except in class 6 (semi-routine occupations).ConclusionsA northwest-southeast divide in social class inequalities existed in Great Britain at the start of the 21st century, with each of the seven social classes having higher rates of poor health in Wales, the North East and North West regions of England than elsewhere. The widest health gap between social classes, however, was in Scotland and London, adding another dimension to the policy debate on resource allocation and targets to tackle the health divide.

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