Variations in self-reported health by occupational grade in the British Post Office: The Q-health project

Between 1995 and 1998 a national sample of 58,501 (42,885 males, 15,616 fem ales) Post Office employees (29%) completed and returned a postal questionn aire survey providing information on demographic characteristics, physical and psychological health, health and lifestyles and health screening behavi our. Response rates by occupational grade were as follows: manual (male 69. 3%, females 43.6%); clerical (male = 11.8%, female, 42.3%); middle manageme nt (males 15.5%, females 10.7%) and senior management (males 3.4%, females 3.3%). A number of differences in health status occurred with occupational grade. Angina, high blood pressure, obesity, smoking, arthritis, disability GP consultations and abnormal smears were all more prevalent in lower occu pational grades. Height, job satisfaction, seat belt use and breast self-ex amination were also lower in lower status jobs. Some findings were unexpect ed: GHQ scores indicated better menial health in lower grades, whilst knowl edge and frequency of testicular self-examination and attendance for mammog rams were higher in lower grades. Self-reports for asthma, diabetes and fam ily history of bowel cancer were also greater in higher grades. These findi ngs are considered in terms of response bias, health selection, the psychos ocial work environment, occupational health interventions and the nature, m eaning and organization of social position within the Post Office.