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Does survey non-response bias the association between occupational social class and health?

Helsinki Collegium for Advanced Studies, University of Helsinki, Finland, Population Research Unit, Department of Sociology, University of Helsinki, Finland, Pekka.Martikainen{at}Helsinki.Fi

Mikko Laaksonen

Department of Public Health, University of Helsinki, Finland

Kustaa Piha

Department of Public Health, University of Helsinki, Finland

Tea Lallukka

Department of Public Health, University of Helsinki, Finland

Aims: A non-response rate of 20—40%is typical in questionnaire studies. The authors evaluate non-response bias and its impact on analyses of social class inequalities in health. Methods: Set in the context of a health survey carried out among the employees of the City of Helsinki (non-response 33%) in 2000—02. Survey response and non-response records were linked with a personnel register to provide information on occupational social class and long sickness absence spells as an indicator of health status. Results: Women and employees in higher occupational social classes were more likely to respond. Non-respondents had about 20—30% higher sickness absence rates. Relative social class differences in sickness absence in the total population were similar to those among either respondents or non-respondents. Conclusions: In working populations survey non-response does not seriously bias analyses of social class inequalities in sickness absence and possibly health inequalities more generally.

Key Words: Bias • health • non-response • occupational social class

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