Study objective - To test the relationship between social class and pr
eventive health behaviour in a British national sample and identify wh
ich set of more specific socioeconomic factors best ''explained'' any
observed relationship(s). Design - Secondary analysis from a national
cross sectional survey of the health attitudes and health behaviour of
men and women aged 18 years and over living in private households in
England, Scotland, and Wales. A selection of addresses was made random
ly from the electoral register using a three stage design, and then on
e individual in each household was sampled. A total of 12254 addresses
yielded interviews with 9003 individuals, a response rate of 73.5%. C
ompared with the census population, the single and divorced/separated
are slightly under-represented but otherwise sources of bias are small
. Participants - The subset selected was 1671 women and 1026 men aged
between 20-45 years with at least one child under 17 living at home. M
ain results - Social class was strongly associated with the health pra
ctices index (HPI, used as a measure of health behaviour) both for wom
en and men (p<0.001). The set of factors identified for both sexes as
having an impact on this relationship were education, tenure, resident
ial overcrowding index, and salience of lifestyle. In addition, their
partner's employment status and household income were relevant for wom
en only. These groups of factors did not totally explain the observed
relationship but the proportion of variance in HPI attributable to soc
ial class was considerably reduced. Conclusions - Descriptions of the
association between social class and health behaviour(s) are of little
use to those wishing to mount more effective interventions in health
promotion. Multivariable analysis can indicate which specific factors
account for much of the social class effect on health behaviour and th
ereby assist better understanding and targeting of resources.