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J Epidemiol Community Health. 1978 December; 32(4): 244–249.
PMCID: PMC1060958

Employment grade and coronary heart disease in British civil servants.


The relationship between grade of employment, coronary risk factors, and coronary heart disease (CHD) mortality has been investigated in a longitudinal study of 17 530 civil servants working in London. After seven and a half years of follow-up there was a clear inverse relationship between grade of employment and CHD mortality. Men in the lowest grade (messengers) had 3.6 times the CHD mortality of men in the highest employment grade (administrators). Men in the lower employment grades were shorter, heavier for their height, had higher blood pressure, higher plasma glucose, smoked more, and reported less leisure-time physical activity than men in the higher grades. Yet when allowance was made for the influence on mortality of all of these factors plus plasma cholesterol, the inverse association between grade of employment and CHD mortality was still strong. It is concluded that the higher CHD mortality experienced by working class men, which is present also in national statistics, can be only partly explained by the established coronary risk factors.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Dyer AR, Stamler J, Shekelle RB, Schoenberger J. The relationship of education to blood pressure: findings on 40,000 employed Chicagoans. Circulation. 1976 Dec;54(6):987–992. [PubMed]
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  • Reid DD, Hamilton PJ, McCartney P, Rose G, Jarrett RJ, Keen H. Smoking and other risk factors for coronary heart-disease in British civil servants. Lancet. 1976 Nov 6;2(7993):979–984. [PubMed]
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  • Syme SL, Oakes TW, Friedman GD, Feldman R, Siegelaub AB, Collen M. Social class and racial differences in blood pressure. Am J Public Health. 1974 Jun;64(6):619–620. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Group