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Patterns of class inequality in health through the lifespan: Class gradients at 15, 35 and 55 years in the west of Scotland

Author

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  • Ford, Graeme
  • Ecob, Russell
  • Hunt, Kate
  • Macintyre, Sally
  • West, Patrick

Abstract

Data confirming the existence of social inequalities in health have continued to accumulate since the Black Report reported class inequalities across a broad range of causes of mortality, with an increasing emphasis on indicators of morbidity and current health status. Although evidence of continuing inequalities mounts, elucidation of underlying mechanisms generating and maintaining such inequalities has been more elusive, and much of the debate has oscillated from the very broad to the very specific. In this paper, the class patterning of a range of non-fatal indicators of health are modelled in an attempt to outline first the adequacy of models of linear relationships for this range of measures, and secondly, the extent to which these are generalizable across a series of age/sex subgroups and across different domains of health. Data are presented here for representative community samples of men and women in adolescence, early- and late-midlife. While orderly relationships between social class and health were seen for the majority of the measures considered; the detailed patterns show considerable diversity. Thus for some aspects of health, notably height (itself often heralded as a broad indicator of health and early life experience), common class gradients were observed for both sexes at each of the stages of the life course examined. For others (notably mental health and presence of chronic illness), gradients were evident in later life but not in adolescence. Others still showed sex but not age differences in class patterning (typically measures of body shape), or no clear patterns (notably blood pressure and consultations with general practitioners). The current analysis draws attention to the consistency of gradients in early- and late-midlife, which are apparent despite the marked increase in the burden of poorer health which manifests between these life stages for almost all indicators of health (an exception being mental health). The challenges which this presents for understanding the mechanisms and processes which have been candidate explanations for social inequalities in health are discussed.

Suggested Citation

  • Ford, Graeme & Ecob, Russell & Hunt, Kate & Macintyre, Sally & West, Patrick, 1994. "Patterns of class inequality in health through the lifespan: Class gradients at 15, 35 and 55 years in the west of Scotland," Social Science & Medicine, Elsevier, vol. 39(8), pages 1037-1050, October.
  • Handle: RePEc:eee:socmed:v:39:y:1994:i:8:p:1037-1050
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    Cited by:

    1. G. David Batty & Abita Bhaskar & Carol Emslie & Michaela Benzeval & Geoff Der & Heather Lewars & Kate Hunt, 2012. "Association of life course socioeconomic disadvantage with future problem drinking and heavy drinking: gender differentials in the west of Scotland," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(1), pages 119-126, February.
    2. Alice Chen & Emily Oster & Heidi Williams, 2014. "Why is Infant Mortality Higher in the US than in Europe?," NBER Working Papers 20525, National Bureau of Economic Research, Inc.
    3. Janet Currie & Mark Stabile, 2003. "Socioeconomic Status and Child Health: Why Is the Relationship Stronger for Older Children?," American Economic Review, American Economic Association, vol. 93(5), pages 1813-1823, December.
    4. Contoyannis, Paul & Li, Jinhu, 2011. "The evolution of health outcomes from childhood to adolescence," Journal of Health Economics, Elsevier, vol. 30(1), pages 11-32, January.
    5. Emslie, Carol & Hunt, Kate, 2008. "The weaker sex? Exploring lay understandings of gender differences in life expectancy: A qualitative study," Social Science & Medicine, Elsevier, vol. 67(5), pages 808-816, September.
    6. Janet Currie & Mark Stabile, 2002. "Socioeconomic Status and Health: Why is the Relationship Stronger for Older Children?," NBER Working Papers 9098, National Bureau of Economic Research, Inc.
    7. Alice Chen & Emily Oster & Heidi Williams, 2016. "Why Is Infant Mortality Higher in the United States Than in Europe?," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 89-124, May.

    More about this item

    Keywords

    inequalities class sex lifecourse;

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