Social dynamics of health inequalities: a growth curve analysis of aging and self assessed health in the British household panel survey 1991–2001

Abstract

Objectives: To study how social inequalities change as people age, this paper presents a growth curve model of self assessed health, which accommodates changes in occupational class and individual health with age. Design: Nationally representative interview based longitudinal survey of adults in Great Britain. Setting: Representative members of private households of Great Britain in 1991. Participants: Survey respondents (n = 6705), aged 21-59 years in 1991 and followed up annually until 2001. Main outcome measure: Self assessed health. Results: On average, self assessed health declines slowly from early adulthood to retirement age. No significant class differences in health were observed at age 21. Health inequalities emerged later in life with the gap between mean levels of self assessed health of those in managerial and professional occupations and routine occupations widening approaching retirement. Individual variability in health trajectories increased between ages 40 and 59 years so that this widening of mean differences between occupational classes was not significant. When the analysis is confined to people whose occupational class remained constant over time, a far greater difference in health trajectories between occupational classes was seen. Conclusions: The understanding of social inequalities in health at the population level is enriched by an analysis of individual variation in age related declines by social position.

Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden

“…Several studies have reported poorer SRH with increasing age, which is consistent with our findings and in line with the increased morbidity with increasing age (McCullough and Laurenceau 2004;Sacker et al 2011;Zack et al 2004). Socioeconomic differences in health have been shown to increase with age (Leopold and Engelhardt 2013;Sacker et al 2005). However, in contrast to the younger age groups, our study showed a time trend towards improved SRH in individuals over 47 years.…”

Adult socioeconomic position, C-reactive protein and interleukin-6 in the Whitehall II prospective study

“…Participants with imputed covariates are subject to misclassification, but excluding these cohort participants left the findings unaffected. While social mobility and drop out from the cohort are likely to dilute differences by SEP [50], social mobility was rather low (7.6%) and analyses restricted to participants with stable SEP did not alter the findings. Follow-up participation rates at Phase 7 were high (81% for CRP and 76% for IL-6).…”

Ten year trends in health inequalities among older people, 1993-2003

“…Self-rated health (SRH) has often been used in studies on health inequalities [1,10], and it is recommended as a health measure by the WHO [11]. Associations of poor SRH with morbidity and mortality are well established among people with different ages.…”