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With its clear hierarchy of porters, clerks and administrators, its rigidly defined pay scales and employment grades, Whitehall is an "exquisitely stratified" bureaucracy, Marmot boasts, an "ideal" environment in which to document the deleterious effects of status on health.
Workers of all employment grades in the central administration offices of these seven ministries aged 25 years and above were invited to participate.
The 12 possible employment grades of the civil service were classified into the three categories analyzed in this study as follows: administrative assistant, administrative officer and executive office (lower), higher executive office and senior executive office (intermediate), grades 7 to 1 (higher).
SES was assessed using participant's employment grades at baseline.
Differences in upper and lower employment grades were associated with 5.4 year difference in life expectancy.
There was a strong social gradient with those in the lowest employment grades being more likely to report limitations (32.5% for ADL and 26.2% for IADL) compared with high employment grades (18.9% for ADL and 11.3% for IADL).
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Individual-level socioeconomic position was measured as most recent employment grade.
It reports relative rates of death from CHD by employment grade, with administrators having a rate of 1.0 by definition.
It reports age adjusted all-cause mortality rate ratios by employment grade, for three periods of follow-up.
Rather, there is a step-wise improvement in health outcomes as one climbs the employment grade ladder.
Within this, the type of occupation, the position, the employment grade, the start and end of the occupational phase were collected.
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