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


METHODS
Nationally representative interview based longitudinal survey of adults in Great Britain.


METHODS
Representative members of private households of Great Britain in 1991.


METHODS
Survey respondents (n = 6705), aged 21-59 years in 1991 and followed up annually until 2001.


METHODS
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.
Sacker
Amanda
A
Department of Epidemiology and Public Health, Royal Free and University College London Medical School, 1-19 Torrington Place, London WC1E 6BT, UK. a.sacker@ucl.ac.uk
Clarke
Paul
P
Wiggins
Richard D
RD
Bartley
Mel
M
D000328:Adult; D000375:Aging; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D012923:Social Class; D012937:Social Mobility / Q000706:statistics & numerical data; D012959:Socioeconomic Factors