Is Social Class Relevant to Uganda?

Social Class is a measure of social position similar to socioeconomic status (SES) (see What is Socioeconomic Status (SES)?). Social class is derived from a combination of work, education  and income and is an indicator that has dramatic effects upon all aspects of life especially education, health and work. Is social class relevant to Uganda, has it been used for research?

The 2007 meta-analysis Health Beliefs, Disease Severity, and Patient Adherence A Meta-Analysis, was a search of all literature published worldwide from 1948-2005 comprising 116 articles. The results from such a survey give robust results that may be applied in a generalizable way. The analysis offers the following conclusion:

Across 27 studies, the average correlation is substantial and comparable in effect size (from meta-analysis) to 2 major predictors of adherence: depression and social support. Perceptions of disease severity threat involve the assessment that a disease to be prevented or treated is serious. This finding suggests the importance of attention to health education, persuasive messages, and the enhancement of patients’ health literacy in promoting adherence. It also points to the importance of the effective management in clinical practice of communication barriers such as language, culture, ethnicity, and social class in helping to enhance patient adherence.

Social class is therefore considered by researchers a valuable tool.

Self-help group meeting

The abstract of the 2004 paper Prevalence of delusional ideation in a district in southwestern Uganda (if this paper sounds familiar I quoted a small passage in Mental Health: Schizophrenia in Uganda), the abstract sums up the over all aim of the paper:

Background: Population-based prevalence studies suggest that psychosis is a continuum distributed in the general population.
Aim: To assess the prevalence of delusional ideation in young healthy individuals in a low-income country setting (Uganda) and to investigate possible relevant background factors.
Method: Interviews were conducted in a district capital and in three rural villages, using the Peters et al. Delusions Inventory (PDI-21).
Results: Levels of delusional ideation and associated levels of distress, preoccupation, and conviction were higher than in studies conducted in Europe. Higher PDI-21 scores were associated with younger age and with urban residence. The urban effect was stronger in persons with a higher level of education.
Conclusions: Although the factors that contribute to population differences in levels of delusional ideation are currently unknown, the results suggest that urban residence may be an important influence.

In this paper social class was analysed to see if it had any effect on delusional ideation. Social was split into middle and high social class versus low social class based on occupation:

Middle/high social class (groups 1 and 2) representing teachers, shopkeepers, students, hairdressers, bartenders, etc., and low social class (group 3) representing unemployed, farmers and artisans.

The results noted that social class was of no statistical significance. However the report found that:

Higher rates of delusional ideation and higher levels of distress and preoccupation were strongly associated with urban residence. Moreover, the urban effect was not explained by differences between urban and rural residents in age, gender, education or social class and was greatest in subjects with higher levels of education.

Social class is a valuable tool for research in the Ugandan setting. It can be used with great effect in the analysis of data. In the example above it identified that social position played no role in the development of schizophrenia. Changes in setting, moving from rural to urban life have a greater effect on the development of schizophrenia.